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Test Sensitivity in the European Prostate Cancer Screening Trial: Results from Finland, Sweden, and the Netherlands

Auvinen, Anssi; Raitanen, Jani; Moss, Sue; de Koning, Harry J.; Hugosson, Jonas; Tammela, Teuvo; Roobol, Monique; Lilja, Hans LU and Hakama, Matti (2009) In Cancer Epidemiology Biomarkers & Prevention 18(7). p.2000-2005
Abstract
Test sensitivity pertains to the ability of a test to identify subjects with the target disorder. In cancer screening, test sensitivity can be estimated using interval cancer incidence as an indicator of false-negative result. A randomized trial provides the optimal approach for estimating test sensitivity, as the control arm provides the expected rates. We estimated the sensitivity of the prostate-specific antigen test using incidence method, i.e., based on incidence of interval cancer among subjects with negative screening results, compared with that in the control arm. Data from three centers in the European randomized screening trial were used to estimate interval cancer incidence (I,) among 39,389 men with negative screening tests.... (More)
Test sensitivity pertains to the ability of a test to identify subjects with the target disorder. In cancer screening, test sensitivity can be estimated using interval cancer incidence as an indicator of false-negative result. A randomized trial provides the optimal approach for estimating test sensitivity, as the control arm provides the expected rates. We estimated the sensitivity of the prostate-specific antigen test using incidence method, i.e., based on incidence of interval cancer among subjects with negative screening results, compared with that in the control arm. Data from three centers in the European randomized screening trial were used to estimate interval cancer incidence (I,) among 39,389 men with negative screening tests. This was compared with incidence among the 79,525 men in the control arm of the trial (I,) to estimate test sensitivity (S = 1 - I-I / I-C). Confidence intervals were calculated using simulations, assuming that the number of cases follows a Poisson distribution. The estimated test sensitivity following the first screen was 0.87 (0.83-0.92) in Finland, 0.87 (0.62-1.00) in Sweden, and 0.93 (95% confidence interval, 0.90-0.96) in the Netherlands. There was some indication of a higher test sensitivity for aggressive cancers (0.85-0.98 for non-organ-confined cases or Gleason 8-10) and for the second screening round (approximately 0.85-0.95). Test sensitivity varied to some extent between the three centers in the European trial, probably reflecting variation in screening protocols, but was acceptable in the first screening round, and may be better for aggressive cancers and in the second screening round. (Cancer Epidemiol Biomarkers Prev 2009;18(7):2000-5) (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Cancer Epidemiology Biomarkers & Prevention
volume
18
issue
7
pages
2000 - 2005
publisher
American Association for Cancer Research
external identifiers
  • wos:000268059700008
  • scopus:67650410006
ISSN
1538-7755
DOI
10.1158/1055-9965.EPI-09-0146
language
English
LU publication?
yes
id
f6f1d6a7-72e7-4a77-864e-c60b5643ba86 (old id 1461749)
date added to LUP
2009-08-31 10:39:34
date last changed
2017-09-24 03:56:39
@article{f6f1d6a7-72e7-4a77-864e-c60b5643ba86,
  abstract     = {Test sensitivity pertains to the ability of a test to identify subjects with the target disorder. In cancer screening, test sensitivity can be estimated using interval cancer incidence as an indicator of false-negative result. A randomized trial provides the optimal approach for estimating test sensitivity, as the control arm provides the expected rates. We estimated the sensitivity of the prostate-specific antigen test using incidence method, i.e., based on incidence of interval cancer among subjects with negative screening results, compared with that in the control arm. Data from three centers in the European randomized screening trial were used to estimate interval cancer incidence (I,) among 39,389 men with negative screening tests. This was compared with incidence among the 79,525 men in the control arm of the trial (I,) to estimate test sensitivity (S = 1 - I-I / I-C). Confidence intervals were calculated using simulations, assuming that the number of cases follows a Poisson distribution. The estimated test sensitivity following the first screen was 0.87 (0.83-0.92) in Finland, 0.87 (0.62-1.00) in Sweden, and 0.93 (95% confidence interval, 0.90-0.96) in the Netherlands. There was some indication of a higher test sensitivity for aggressive cancers (0.85-0.98 for non-organ-confined cases or Gleason 8-10) and for the second screening round (approximately 0.85-0.95). Test sensitivity varied to some extent between the three centers in the European trial, probably reflecting variation in screening protocols, but was acceptable in the first screening round, and may be better for aggressive cancers and in the second screening round. (Cancer Epidemiol Biomarkers Prev 2009;18(7):2000-5)},
  author       = {Auvinen, Anssi and Raitanen, Jani and Moss, Sue and de Koning, Harry J. and Hugosson, Jonas and Tammela, Teuvo and Roobol, Monique and Lilja, Hans and Hakama, Matti},
  issn         = {1538-7755},
  language     = {eng},
  number       = {7},
  pages        = {2000--2005},
  publisher    = {American Association for Cancer Research},
  series       = {Cancer Epidemiology Biomarkers & Prevention},
  title        = {Test Sensitivity in the European Prostate Cancer Screening Trial: Results from Finland, Sweden, and the Netherlands},
  url          = {http://dx.doi.org/10.1158/1055-9965.EPI-09-0146},
  volume       = {18},
  year         = {2009},
}