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  • Carlsson, Sigrid V.Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology (author)

Estimating the harms and benefits of prostate cancer screening as used in common practice versus recommended good practice : A microsimulation screening analysis

  • Article/chapterEnglish2016

Publisher, publication year, extent ...

  • 2016-07-26
  • Wiley,2016
  • 8 s.
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:e2639370-d4b4-422a-98e4-7d7b4804d73a
  • https://lup.lub.lu.se/record/e2639370-d4b4-422a-98e4-7d7b4804d73aURI
  • https://doi.org/10.1002/cncr.30192DOI
  • https://gup.ub.gu.se/publication/243955URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • BACKGROUND: Prostate-specific antigen (PSA) screening and concomitant treatment can be implemented in several ways. The authors investigated how the net benefit of PSA screening varies between common practice versus “good practice.”. METHODS: Microsimulation screening analysis (MISCAN) was used to evaluate the effect on quality-adjusted life-years (QALYs) if 4 recommendations were followed: limited screening in older men, selective biopsy in men with elevated PSA, active surveillance for low-risk tumors, and treatment preferentially delivered at high-volume centers. Outcomes were compared with a base model in which annual screening started at ages 55 to 69 years and were simulated using data from the European Randomized Study of Screening for Prostate Cancer. RESULTS: In terms of QALYs gained compared with no screening, for 1000 screened men who were followed over their lifetime, recommended good practice led to 73 life-years (LYs) and 74 QALYs gained compared with 73 LYs and 56 QALYs for the base model. In contrast, common practice led to 78 LYs gained but only 19 QALYs gained, for a greater than 75% relative reduction in QALYs gained from unadjusted LYs gained. The poor outcomes for common practice were influenced predominantly by the use of aggressive treatment for men with low-risk disease, and PSA testing in older men also strongly reduced potential QALY gains. CONCLUSIONS: Commonly used PSA screening and treatment practices are associated with little net benefit. Following a few straightforward clinical recommendations, particularly greater use of active surveillance for low-risk disease and reducing screening in older men, would lead to an almost 4-fold increase in the net benefit of prostate cancer screening. Cancer 2016;122:3386–3393.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • de Carvalho, Tiago M.Erasmus University Medical Center (author)
  • Roobol, Monique J.Erasmus University Medical Center (author)
  • Hugosson, Jonas,1955Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology(Swepub:gu)xhugjo (author)
  • Auvinen, AnssiUniversity of Tampere (author)
  • Kwiatkowski, MaciejStädtische Klinikum Braunschweig (author)
  • Villers, ArnauldUniversity of Lille (author)
  • Zappa, MarcoCancer Research and Prevention Institute (ISPO) (author)
  • Nelen, VeraProvinciaal Instituut voor Hygiëne (author)
  • Páez, AlvaroFuenlabrada University Hospital (author)
  • Eastham, James A.Memorial Sloan-Kettering Cancer Center (author)
  • Lilja, HansLund University,Lunds universitet,Klinisk kemi, Malmö,Forskargrupper vid Lunds universitet,Clinical Chemistry, Malmö,Lund University Research Groups,University of Oxford,Memorial Sloan-Kettering Cancer Center(Swepub:lu)klke-hli (author)
  • de Koning, Harry J.Erasmus University Medical Center (author)
  • Vickers, Andrew J.Memorial Sloan-Kettering Cancer Center (author)
  • Heijnsdijk, Eveline A MErasmus University Medical Center (author)
  • Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för urologi (creator_code:org_t)

Related titles

  • In:Cancer: Wiley122:21, s. 3386-33930008-543X1097-0142

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