Tampere School of Public Health, University of Tampere, Tampere, Finland.
As with wide-spread use of prostate cancer screening with prostate-specific antigen testing, overdetection has increasingly gained attention. The authors aimed to estimate absolute risk of overdetection in prostate cancer screening with various inter-screening intervals and ages at start of screening. We estimated age-specific pre-clinical incidence rates (per 100,000 person-years) for progressive cancer (from 128 for age group 55-58 years to 774 for age group 67-71 years) and non-progressive cancer (from 40 for age group 55-58 years to 66 for age group 67-71 years), the mean sojourn time (7.72 years) and the sensitivity (42.8% at first screen and 59.8% at the second screen) by using a multi-step epidemiological model with data from the Finnish randomized controlled trial. The overall number of screens for overdetection (NSO) was 29 (95% CI: 18, 48) for screenees aged 55-67 years, equivalent to 3.4 (9% CI: 2.1, 5.7) overdetected prostate cancers per 100 screenees. The NSO decreased from 63 (95% CI: 37, 109) at the first screen to 29 (95% CI: 18, 48) at the third screen, and from 43 (95% CI: 36, 52) for age 55 years to 25 (95% CI: 8, 75) at age 67 years at the first screen. In conclusion, around 3.4 cases for every 100 screened men would be overdetected during three screen rounds (approximately 13 years of follow-up) in the Finnish randomized controlled trial. Elucidating the absolute risk of overdetection under various scenarios makes contribution to evaluating the benefit and harm of prostate cancer screening.
Written by:
Wu GH, Auvinen A, Määttänen L, Tammela TL, Stenman UH, Hakama M, Yen AM, Chen HH. Are you the author?
Reference: Int J Cancer. 2011 Nov 2. Epub ahead of print.
doi: 10.1002/ijc.27340
PubMed Abstract
PMID: 22052356
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