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Prostate Cancer Screening: A Review of the Guidelines [Internet]

Prostate cancer is the third leading cause of cancer death in Canadian men. The lifetime risk of developing prostate cancer is estimated around 14.2%, while the risk of dying from this cancer is 3.7%. In most cases, prostate cancer grows slowly and most men die due to causes other than prostate cancer even before the cancer becomes clinically evident.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: November 29, 2013

Stepwise Approach for the Prescription of Opiates for Non-Cancer Pain: A Review of Clinical Evidence and Guidelines [Internet]

The terms opiate and opioid are often used interchangeably. Opiates are medications derived from opium poppy such as morphine and codeine, while opioids refer to opium-like substances including endogenous substances such as endorphins, as well as exogenous synthetic drugs that interact with opioid receptors. The generic term “Opioid” (including opiates and opioids) is therefore the preferred term for use throughout this report.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: May 12, 2014

Screening for Skin Cancer: An Update of the Evidence for the U.S. Preventive Services Task Force [Internet]

Skin cancer is the most commonly diagnosed cancer in the United States. The majority of skin cancers are non-melanoma cancers, either basal cell cancer or squamous cell cancer. The incidence of both melanoma and non-melanoma skin cancer has been increasing over the last three decades.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: February 2009

Long-acting Opioids for Chronic Non-cancer Pain: A Review of the Clinical Efficacy and Safety [Internet]

Opioid analgesics are used widely in the treatment of chronic pain. The majority of evidence, however, is from studies on short term use, and opioids are associated with individual adverse events of sedation, cognitive slowing, respiratory depression, overdose, and substance dependence. Upward trends of prescription of opioids have been associated with increased reports of opioid-related deaths, addiction, and drug diversion. It, therefore, is important that opioid prescription be tailored appropriately to need.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: August 27, 2015

Screening for Breast Cancer With Digital Breast Tomosynthesis [Internet]

Digital breast tomosynthesis (DBT) has rapidly been adopted by many providers of mammography screening in the United States. This report summarizes the evidence published through October 2015 regarding the diagnostic test characteristics of tomosynthesis in screening populations.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: January 2016

Behavioural and Psychological Interventions for Chronic Non-Cancer Pain: A Review of Guidelines [Internet]

The aim of this report is to review the guidelines regarding the behavioural and psychological interventions for chronic non-cancer pain.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: November 22, 2016

Nutritional Supplementation for Patients with Cancer: A Review of the Clinical Effectiveness and Guidelines [Internet]

People with cancer who are well nourished and who are capable of maintaining a healthy body weight may have better outcomes than patients who are undernourished or underweight. Survival is generally shorter for those patients who lose weight prior to starting cancer treatment. Maintaining a healthy diet through cancer treatment may help maintain the immune system and the general well-being of patients. Weight and nutrition can be managed by eating more protein, eating more calories, drinking more water, and reducing alcohol consumption. Calories and protein may come from foods that would regularly be consumed in the diet or through high-calorie and high-protein shakes or beverages. When ingesting adequate nutrition by mouth is not a possibility due to nausea, swallowing difficulty, or a very sore mouth or throat, alternative feeding methods could be necessary. These methods may include providing fluids and nutrition through a feeding tube (enteral nutrition) or intravenous line (parenteral nutrition).

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: February 12, 2014

Radiation Emissions from Computed Tomography: A Review of the Risk of Cancer and Guidelines [Internet]

Computed tomography (CT) is a medical imaging technology used for the screening and diagnosis of medical conditions. It involves taking numerous X-ray images of a body area or organ and these images are reconstituted into computer-generated pictures.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: June 4, 2014

Screening Adults for Bladder Cancer: Update of the 2004 Evidence Review for the US Preventive Services Task Force [Internet]

Bladder cancer is one of the 10 most frequently diagnosed cancers. Screening could identify high-grade bladder cancer at earlier stages, when it may be more easily and effectively treated.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: October 2010

Cannabinoid Buccal Spray for Chronic Non-Cancer or Neuropathic Pain: A Review of Clinical Effectiveness, Safety, and Guidelines [Internet]

Chronic pain is a complex, severe and debilitating condition which can lead to a considerable reduction in function and quality of life. Patients may present with different forms of chronic pain resulting from a number of identifiable causes, including pain due to lesion or dysfunction of the nerves, spinal cord or brain (neuropathic pain), or persistent pain caused by other non-malignant conditions, such as low-back pain or pain due to inflammation of various arthritic conditions. The prevalence of chronic non-cancer pain or neuropathic pain among Canadian adults is not well known. However, prevalence estimates using large, population-based questionnaires have shown that 4% to 8% of the general population in the developed world experiences neuropathic pain, suggesting that approximately two million Canadians may be affected by this disabling condition. Chronic pain is of particular concern among Canadians aged 65 years and older; based on cross-sectional data from the 1996/1997 National Population Health Survey and the 2005 Canadian Community Health Survey, chronic pain was estimated to affect 27% and 38% of seniors living in households and health care institutions, respectively.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: September 21, 2016

Prostate-Specific Antigen-Based Screening for Prostate Cancer: An Evidence Update for the U.S. Preventive Services Task Force [Internet]

In 2008, the U.S. Preventive Services Task Force (USPSTF) concluded that the evidence was insufficient to assess the balance of benefits and harms of screening for prostate cancer in men younger than age 75 years. The USPSTF recommended against screening for prostate cancer in men aged 75 years or older.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: October 2011

Low-Dose Computed Tomography for Lung Cancer Screening: A Review of the Clinical Effectiveness, Diagnostic Accuracy, Cost-Effectiveness, and Guidelines [Internet]

Lung cancer is the leading cause of cancer-related deaths, worldwide. Complex interactions between genetic, hormonal, behavioural, and environmental factors play a role in the development of lung cancer. Smoking is a major risk factor for lung cancer and accounts for 80% of the lung cancers in men and at least 50% of the lung cancers in women, worldwide. It is estimated that in 2015, 26,600 Canadians will be diagnosed with lung cancer which represents 14% of all new cancers detected and that 20,900 Canadians will die from lung cancer, which represents 27% of all cancer deaths in Canada in 2015. In Canada, the 5-year survival rate for lung cancer patients is 14% and is considerably lower compared with 5-year survival rate for other cancers such as 95% for prostate cancer, 88% for breast cancer, and 65% for colorectal cancer. A contributor to the lower survival rate is the fact that lung cancer is generally diagnosed at an advanced stage when patients present with symptoms and when cure by surgery is unlikely. Screening strategies enabling detection of lung cancer at an early stage could potentially lead to decreased mortality. Screening strategies for lung cancer include conventional radiography, sputum cytology, and the more recent low-dose computed tomography (LDCT). Results with conventional radiography and sputum cytology have been shown to detect slightly more early-stage lung cancers, though this was not accompanied by a reduction in advanced lung cancer detection and did not lead to a reduction in mortality. A large randomized controlled trial, the National Lung Cancer Screening Trial (NLST) showed that with LDCT screening, a 20% reduction in mortality was achieved. However, the false-positive rate is high for screening with LDCT and this can lead to harm due to unnecessary workups of benign nodules. Hence there is debate regarding the use of LDCT for lung cancer screening.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: September 22, 2015

Update on Emerging Genetic Tests Currently Available for Clinical Use in Common Cancers [Internet]

The Coverage and Analysis Group at the Centers for Medicare and Medicaid Services (CMS) requested that the Technology Assessment Program (TAP) of the Agency for Healthcare Research and Quality (AHRQ) conduct an update of genetic tests for cancer conditions that were identified since the 2011 horizon scan report on Genetic Testing for Cancer. AHRQ assigned this project to the Tufts Medical Center Evidence-based Practice Center (Contract Number: HHSA 290 2007 10055 I, Task Order #11).

Technology Assessment Report - Agency for Healthcare Research and Quality (US).

Version: July 19, 2013

Screening for Skin Cancer in Adults: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet]

Melanoma is the leading cause of skin cancer mortality. Visual skin examination for skin cancer screening could impact disease incidence and mortality in U.S. adults and adolescents.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: July 2016

Screening for Lung Cancer: Systematic Review to Update the U.S. Preventive Services Task Force Recommendation [Internet]

Lung cancer is the leading cause of cancer-related death in the United States. However, persons with early lung cancer have lower lung cancer–related mortality than those with extensive disease, suggesting early detection and treatment of lung cancer might be beneficial. Low-dose computed tomography (LDCT) and chest x-ray (CXR) have been studied for early screening, with several new studies reporting results since the last review.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: July 2013

Clinical effectiveness of first-line chemoradiation for adult patients with locally advanced non-small cell lung cancer: a systematic review

This review found that the research conducted in the area of chemoradiation for adult patients with locally advanced non-small cell lung cancer was generally of poor quality and suffered from a lack of reporting of all important clinical findings. The trials included in the systematic review were too disparate to form any firm conclusions as to the effectiveness of individual chemotherapy agents or types of radiotherapy.

Health Technology Assessment - NIHR Journals Library.

Version: February 2013

Gene expression profiling and expanded immunohistochemistry tests to guide the use of adjuvant chemotherapy in breast cancer management: a systematic review and cost-effectiveness analysis

Study found that the clinical evidence base for OncotypeDX is the most robust, with studies on OncotypeDX offering evidence of the predictive benefits offered by the test, and that, of the four tests considered, treatment guided using IHC4 has the most potential to be cost-effective at typical willingness-to-pay thresholds but that the evidence base to support IHC4 needs significant further research.

Health Technology Assessment - NIHR Journals Library.

Version: October 2013

Imaging for the Pretreatment Staging of Small Cell Lung Cancer [Internet]

For small cell lung cancer (SCLC), several imaging modalities can be used to determine cancer staging, which is important to ensure optimal management. Our aim was to synthesize the literature on whether some imaging modalities are better than others for the pretreatment staging of small cell lung cancer. We searched for evidence on comparative accuracy (sensitivity, specificity) as well as subsequent clinical outcomes (choice of treatment, survival, and quality of life).

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: April 2016

Screening for Breast Cancer: Systematic Evidence Review Update for the US Preventive Services Task Force [Internet]

This systematic review is an update of new evidence since the 2002 U.S. Preventive Services Task Force recommendation on breast cancer screening.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: November 2009

Aspirin Use in Adults: Cancer, All-Cause Mortality, and Harms: A Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet]

Cancer is the second leading cause of death in United States. The net benefit for aspirin (ASA) in cardiovascular disease (CVD) primary prevention is controversial due to increased risks from bleeding alongside relatively modest cardiovascular benefits. Consideration of additional cancer prevention effects might clarify whether long-term, low-dose ASA may offer an overall health benefit for the two top causes of mortality in the United States.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: September 2015

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