Quantifying the role of PSA screening in the US prostate cancer mortality decline. Cancer Causes Control 2008 Mar;19(2):175-81
Date
11/21/2007Pubmed ID
18027095Pubmed Central ID
PMC3064270DOI
10.1007/s10552-007-9083-8Scopus ID
2-s2.0-38949085322 (requires institutional sign-in at Scopus site) 324 CitationsAbstract
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 EAuthor
Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Forecasting
Humans
Male
Mass Screening
Middle Aged
Models, Theoretical
Prostate-Specific Antigen
Prostatic Neoplasms
SEER Program
United States
