Prostate cancer: a systems approach overview

Systems thinking is a set of methodologies that facilitate analysis and predictions for a complex system in a holistic way. Prostate cancer has precursor stages that are difficult to detect and a number of different therapy options for different stages, so it is a complex disease to manage within healthcare systems. In this review we show how systems thinking, especially causal loop diagrams, can be a very valuable tool for gaining greater insight into the pathogenesis and diagnosis of prostate cancer and to predict the consequences in major changes in the pattern of healthcare for this disease, e.g. introduction of national screening programmes using serum prostate specific antigen. The systems thinking approach can be used to predict changes in histopathology workflow when other parts of the system are changed. © 2008 Elsevier Ltd. All rights reserved.