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Lead time associated with screening for prostate cancer

Tornblom, M; Eriksson, H; Franzen, S; Gustafsson, O; Lilja, Hans LU ; Norming, U and Hugosson, J (2004) In International Journal of Cancer 108(1). p.122-129
Abstract
Screening serum levels of prostate-specific antigen (PSA) is now a major strategy for early detection of prostate cancer (PC). Quantification of the lead time thus obtained is important both for understanding the development of PC and for evaluating the advantages and disadvantages of widespread screening. In our study, 1,233 randomly selected men living in Stockholm in 1988 were invited to participate in an early detection (ED) program, in which suspicious findings provided by digital rectal examination (DRE), transrectal ultrasonography (TRUS) and/or a PSA value greater than or equal to10.0 ng/mL were followed up by biopsy. The cumulative incidence (Kaplan-Meier) of PC in the 946 participants (ED) during 12 years of follow-up was... (More)
Screening serum levels of prostate-specific antigen (PSA) is now a major strategy for early detection of prostate cancer (PC). Quantification of the lead time thus obtained is important both for understanding the development of PC and for evaluating the advantages and disadvantages of widespread screening. In our study, 1,233 randomly selected men living in Stockholm in 1988 were invited to participate in an early detection (ED) program, in which suspicious findings provided by digital rectal examination (DRE), transrectal ultrasonography (TRUS) and/or a PSA value greater than or equal to10.0 ng/mL were followed up by biopsy. The cumulative incidence (Kaplan-Meier) of PC in the 946 participants (ED) during 12 years of follow-up was compared to that of an age-matched, randomly selected reference population (RP) of 657 men for whom PSA values (from frozen serum samples) could also be obtained. The PC incidence in men in the RP with PSA values >3.0 ng/mL reached the corresponding level for the ED group after 10.6 years (the "catch-up" point). After 12 years of follow-up, the estimated median lead time for men with PSA values in this interval was 4.5 years in the ED population, compared to 7.8 years in the RP. With 20 years of follow-up, the estimated median lead time of the RP was enhanced to 10.7 years. The lead time in connection with PC was influenced by the initial PSA level (although with large variations), length of follow-up and sensitivity of the ED procedure employed. The ED program described here was not associated with major overdetection. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
prostate-specific antigen, prostate cancer, lead time, diagnosis, epidemiology
in
International Journal of Cancer
volume
108
issue
1
pages
122 - 129
publisher
John Wiley & Sons
external identifiers
  • wos:000186718300019
  • scopus:0344825113
ISSN
0020-7136
DOI
10.1002/ijc.11554
language
English
LU publication?
yes
id
62251be9-c110-46bf-84a9-db1194244a26 (old id 294565)
date added to LUP
2007-10-26 09:19:47
date last changed
2017-11-05 03:36:08
@article{62251be9-c110-46bf-84a9-db1194244a26,
  abstract     = {Screening serum levels of prostate-specific antigen (PSA) is now a major strategy for early detection of prostate cancer (PC). Quantification of the lead time thus obtained is important both for understanding the development of PC and for evaluating the advantages and disadvantages of widespread screening. In our study, 1,233 randomly selected men living in Stockholm in 1988 were invited to participate in an early detection (ED) program, in which suspicious findings provided by digital rectal examination (DRE), transrectal ultrasonography (TRUS) and/or a PSA value greater than or equal to10.0 ng/mL were followed up by biopsy. The cumulative incidence (Kaplan-Meier) of PC in the 946 participants (ED) during 12 years of follow-up was compared to that of an age-matched, randomly selected reference population (RP) of 657 men for whom PSA values (from frozen serum samples) could also be obtained. The PC incidence in men in the RP with PSA values >3.0 ng/mL reached the corresponding level for the ED group after 10.6 years (the "catch-up" point). After 12 years of follow-up, the estimated median lead time for men with PSA values in this interval was 4.5 years in the ED population, compared to 7.8 years in the RP. With 20 years of follow-up, the estimated median lead time of the RP was enhanced to 10.7 years. The lead time in connection with PC was influenced by the initial PSA level (although with large variations), length of follow-up and sensitivity of the ED procedure employed. The ED program described here was not associated with major overdetection.},
  author       = {Tornblom, M and Eriksson, H and Franzen, S and Gustafsson, O and Lilja, Hans and Norming, U and Hugosson, J},
  issn         = {0020-7136},
  keyword      = {prostate-specific antigen,prostate cancer,lead time,diagnosis,epidemiology},
  language     = {eng},
  number       = {1},
  pages        = {122--129},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {Lead time associated with screening for prostate cancer},
  url          = {http://dx.doi.org/10.1002/ijc.11554},
  volume       = {108},
  year         = {2004},
}