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Quantifying the role of PSA screening in the US prostate cancer mortality decline. Cancer Causes Control 2008 Mar;19(2):175-81 PMID: 18027095 PMCID: PMC3064270

Pubmed ID

18027095

Abstract

OBJECTIVE: To quantify the plausible contribution of prostate-specific antigen (PSA) screening to the nearly 30% decline in the US prostate cancer mortality rate observed during the 1990s.

METHODS: Two mathematical modeling teams of the US National Cancer Institute's Cancer Intervention and Surveillance Modeling Network independently projected disease mortality in the absence and presence of PSA screening. Both teams relied on Surveillance, Epidemiology, and End Results (SEER) registry data for disease incidence, used common estimates of PSA screening rates, and assumed that screening, by shifting disease from distant to local-regional clinical stage, confers a corresponding improvement in disease-specific survival.

RESULTS: The teams projected similar mortality increases in the absence of screening and decreases in the presence of screening after 1985. By 2000, the models projected that 45% (Fred Hutchinson Cancer Research Center) to 70% (University of Michigan) of the observed decline in prostate cancer mortality could be plausibly attributed to the stage shift induced by screening.

CONCLUSIONS: PSA screening may account for much, but not all, of the observed drop in prostate cancer mortality. Other factors, such as changing treatment practices, may also have played a role in improving prostate cancer outcomes.

Author List

Etzioni R, Tsodikov A, Mariotto A, Szabo A, Falcon S, Wegelin J, DiTommaso D, Karnofski K, Gulati R, Penson DF, Feuer E

Author

Aniko Szabo PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-38949085322   226 Citations

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Forecasting
Humans
Male
Mass Screening
Middle Aged
Models, Theoretical
Prostate-Specific Antigen
Prostatic Neoplasms
SEER Program
United States
jenkins-FCD Prod-299 9ef562391eceb2b8f95265c767fbba1ce5a52fd6