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Mean sojourn time, overdiagnosis, and reduction in advanced stage prostate cancer due to screening with PSA: implications of sojourn time on screening

By N Pashayan, S W Duffy, P Pharoah, D Greenberg, J Donovan, R M Martin, F Hamdy and D E Neal


This study aimed to assess the mean sojourn time (MST) of prostate cancer, to estimate the probability of overdiagnosis, and to predict the potential reduction in advanced stage disease due to screening with PSA. The MST of prostate cancer was derived from detection rates at PSA prevalence testing in 43 842 men, aged 50–69 years, as part of the ProtecT study, from the incidence of non-screen-detected cases obtained from the English population-based cancer registry database, and from PSA sensitivity obtained from the medical literature. The relative reduction in advanced stage disease was derived from the expected and observed incidences of advanced stage prostate cancer. The age-specific MST for men aged 50–59 and 60–69 years were 11.3 and 12.6 years, respectively. Overdiagnosis estimates increased with age; 10–31% of the PSA-detected cases were estimated to be overdiagnosed. An interscreening interval of 2 years was predicted to result in 37 and 63% reduction in advanced stage disease in men 65–69 and 50–54 years, respectively. If the overdiagnosed cases were excluded, the estimated reductions were 9 and 54%, respectively. Thus, the benefit of screening in reducing advanced stage disease is limited by overdiagnosis, which is greater in older men

Topics: Epidemiology
Publisher: Nature Publishing Group
OAI identifier:
Provided by: PubMed Central

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  1. (2002). Cancer Inst 97(6): 433–438
  2. from the initial screening round of a randomized trial.
  3. (2003). Lane A
  4. (2003). Lead times and overdetection due to prostatespecific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. JN a t lC a n c e rI n s t95(12): 868–878 el-Galley
  5. (1994). Prostate-specific antigen and digital rectal examination in screening for prostate cancer: a community-based study.
  6. (2002). Prostate-specific antigen testing accuracy in community practice.
  7. (1995). Syst Rev 3: CD004720
  8. (1994). yAppendix A Description of the studies used to derive age-specific sensitivity of PSA test Paper Age Study size PSA cut-off (ngml 1) Sensitivity % Study setting Stenman et al

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