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Estimating the harm...
Estimating the harms and benefits of prostate cancer screening as used in common practice versus recommended good practice : A microsimulation screening analysis
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- Carlsson, Sigrid V. (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology
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- de Carvalho, Tiago M. (author)
- Erasmus University Medical Center
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- Roobol, Monique J. (author)
- Erasmus University Medical Center
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- Hugosson, Jonas, 1955 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology
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- Auvinen, Anssi (author)
- University of Tampere
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- Kwiatkowski, Maciej (author)
- Städtische Klinikum Braunschweig
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- Villers, Arnauld (author)
- University of Lille
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- Zappa, Marco (author)
- Cancer Research and Prevention Institute (ISPO)
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- Nelen, Vera (author)
- Provinciaal Instituut voor Hygiëne
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- Páez, Alvaro (author)
- Fuenlabrada University Hospital
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- Eastham, James A. (author)
- Memorial Sloan-Kettering Cancer Center
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- Lilja, Hans (author)
- Lund 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
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- de Koning, Harry J. (author)
- Erasmus University Medical Center
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- Vickers, Andrew J. (author)
- Memorial Sloan-Kettering Cancer Center
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- Heijnsdijk, Eveline A M (author)
- Erasmus University Medical Center
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(creator_code:org_t)
- 2016-07-26
- 2016
- English 8 s.
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In: Cancer. - : Wiley. - 0008-543X .- 1097-0142. ; 122:21, s. 3386-3393
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https://portal.resea... (primary) (free)
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http://dx.doi.org/10...
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https://europepmc.or...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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https://gup.ub.gu.se...
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Abstract
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- 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
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Keyword
- early detection of cancer/adverse effects
- mass screening
- prostate-specific antigen/blood
- prostatic neoplasms
- quality of life
- quality-adjusted-life-years
Publication and Content Type
- art (subject category)
- ref (subject category)
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Cancer
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Carlsson, Sigrid ...
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de Carvalho, Tia ...
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Roobol, Monique ...
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Hugosson, Jonas, ...
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Auvinen, Anssi
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Kwiatkowski, Mac ...
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Villers, Arnauld
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Zappa, Marco
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Nelen, Vera
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Páez, Alvaro
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Eastham, James A ...
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Lilja, Hans
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de Koning, Harry ...
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Vickers, Andrew ...
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Heijnsdijk, Evel ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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Cancer
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Lund University
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University of Gothenburg