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dc.contributor.authorFinne, Pen_US
dc.contributor.authorFallah, Men_US
dc.contributor.authorHakama, Men_US
dc.contributor.authorCiatto, Sen_US
dc.contributor.authorHugosson, Jen_US
dc.contributor.authorde Koning, Hen_US
dc.contributor.authorMoss, Sen_US
dc.contributor.authorNelen, Ven_US
dc.contributor.authorAuvinen, Aen_US
dc.identifier17, SIen_US
dc.identifier.citationEUROPEAN JOURNAL OF CANCER, 2010, 46 pp. 3102 - 3108en_US
dc.description.abstractBackground: Lead-time is defined as the time by which screening advances the diagnosis compared with absence of screening. A sufficiently long lead-time needs to be achieved so that cancer can be detected while still curable. A very short lead-time may indicate poor sensitivity of the screening test, while a very long lead-time suggests overdiagnosis. Material and methods: In the first screening round, a total of 56,294 men aged 55-74 years were screened with serum prostate specific antigen (PSA) in five countries of the European Randomised Study of Screening for Prostate Cancer (ERSPC) with an overall detection rate (prevalence) of 2.8% (1972 prostate cancers). Prostate cancer incidence among 92,142 men randomly allocated to the control arm of the trial was also assessed. Lead-time was estimated as the time required to accumulate a similar cumulative risk of prostate cancer in the control arm to the detection rate in the intervention arm, i.e. from the ratio of detection rate (prevalence of screen-detected cases) and expected incidence (cumulative risk). Results: Using a serum PSA cut-off of 4 ng/ml, the mean lead-time in the whole study population was estimated as 6.8 years (95% confidence interval (95% CI) 7.9-8.4). It was 8 years in The Netherlands, 6 in Sweden and Finland, 5 in Italy and 4 in Belgium. The mean lead-time was similar, 6-7 years, at ages 50-64 years, but close to 8 years among men aged 65-74 years. A lower PSA cut-off level of 3 ng/ml used in Sweden and The Netherlands prolonged the mean lead-time by approximately 1 year. Lead-time based on advanced prostate cancer only was slightly shorter, mean 5.3 years (95% CI 4.6-6.0). The lead-time for the second screening round was slightly shorter than that for the first (5.9, 95% CI 5.4-6.4), reflecting a similar relation between detection rate and control group incidence. Conclusion: The lead-time for prostate cancer found in ERSPC substantially exceeded that found for breast, cervical and colorectal cancer screening. One round of prostate cancer screening can advance clinical diagnosis by 4-8 years. Overdiagnosis or detection of non-progressive tumours may contribute substantially to the lead-time. (C) 2010 Published by Elsevier Ltd.en_US
dc.format.extent3102 - 3108en_US
dc.publisherELSEVIER SCI LTDen_US
dc.titleLead-time in the European Randomised Study of Screening for Prostate Canceren_US
dc.typeJournal Article
rioxxterms.typeJournal Article/Reviewen_US
pubs.notesaffiliation: Auvinen, A (Reprint Author), Tampere Univ, Tampere Sch Publ Hlth, FI-33014 Tampere, Finland. Finne, Patrik; Fallah, Mandi; Hakama, Matti; Auvinen, Anssi, Univ Tampere, Sch Publ Hlth, FIN-33101 Tampere, Finland. Fallah, Mandi, Tampere Univ Hosp, Tampere, Finland. Hakama, Matti, Finnish Canc Registry, FIN-00170 Helsinki, Finland. Ciatto, Stefano, Ist Studio & Prevenz Oncol, Florence, Italy. Hugosson, Jonas, Sahlgrens Univ Hosp, Dept Urol, Gothenburg, Sweden. de Koning, Harry, Erasmus Univ, Med Ctr, Dept Publ Hlth, Rotterdam, Netherlands. Moss, Sue, Inst Canc Res, Surrey, England. Nelen, Vera, Prov Inst Hyg, Dept Publ Hlth, Antwerp, Belgium. keywords: Prostate neoplasms; Mass screening; Prostate-specific antigen; Randomised trials keywords-plus: INCIDENCE TRENDS; ANTIGEN; OVERDIAGNOSIS; PROGRAMS; DISEASE; MODEL research-areas: Oncology web-of-science-categories: Oncology author-email: orcid-numbers: Auvinen, Anssi/0000-0003-1125-4818 Fallah, Mahdi/0000-0002-6639-065X funding-acknowledgement: Beckman-Coulter Inc. funding-text: The European Randomised Study of Prostate Cancer Screening (ERSPC) has received funding as unrestricted grant from Beckman-Coulter Inc. The funding source has had no role in decisions about publication, their contents or timing and has no involvement in preparing the publications of the trial. number-of-cited-references: 19 times-cited: 38 usage-count-last-180-days: 0 usage-count-since-2013: 1 journal-iso: Eur. J. Cancer doc-delivery-number: 689IX unique-id: ISI:000284922400010 da: 2018-08-17en_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Cancer Screening Evaluation Unit (DoH)
pubs.embargo.termsNot knownen_US
icr.researchteamCancer Screening Evaluation Unit (DoH)en_US
dc.contributor.icrauthorMoss, Susan Maryen_US

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