ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2011
What is the true number needed to screen and treat to save a life with prostate-specific antigen testing?
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 97 citations in OpenAlex.
- Systematic Review on the Cost Effectiveness of Prostate Cancer Screening in Europe.European urology · 2024Pooled it
- Pooled it
- Prostate-cancer mortality at 11 years of follow-up.The New England journal of medicine · 2012Trial
- Time-constant absolute effect measures for time-to-event outcomes.BMC medical research methodology · 2025Article
- Pancreatic cancer: from early detection to personalized treatment approaches.Annals of medicine and surgery (2012) · 2024Review
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- Identification of novel molecular subtypes and a signature to predict prognosis and therapeutic response based on cuproptosis-related genes in prostate cancer.Frontiers in oncology · 2023Article
- A novel defined risk signature based on pyroptosis-related genes can predict the prognosis of prostate cancer.BMC medical genomics · 2022Article
- Effect of Perceived Self-Vulnerability on Prostate Cancer Screening Uptake and Associated Factors: A Cross-Sectional Study of Public Health Facilities in Western Kenya.Annals of global health · 2022Article
- Article
- Urban-Rural Differences in Clinical Characteristics of Prostate Cancer at Initial Diagnosis: A Single-Center Observational Study in Anhui Province, China.Frontiers in oncology · 2021Article
- Examining Lung Cancer Screening Behaviors in the Primary Care Setting: A Mixed Methods Approach.Journal of cancer treatment and research · 2019Article
- Rethinking active surveillance for prostate cancer in African American men.Translational andrology and urology · 2018Review
- [Reply to: PSA screening : Possible uses and harm by N. Keller, M. Jenny, G. Gigerenzer, R. Ablin].Der Urologe. Ausg. A · 2018Article
- Impact of surveillance for hepatocellular carcinoma on survival in patients with compensated cirrhosis.Hepatology (Baltimore, Md.) · 2018Article
- Economic Analysis of Prostate-Specific Antigen Screening and Selective Treatment Strategies.JAMA oncology · 2016Article
- Proteomic Profiling of Serum-Derived Exosomes from Ethnically Diverse Prostate Cancer Patients.Cancer investigation · 2016Article
- The path to routine use of genomic biomarkers in the cancer clinic.Genome research · 2015Review
- Overdiagnosis and overtreatment of prostate cancer.European urology · 2014Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
purposeThe European Randomized Study of Screening for Prostate Cancer (ERSPC) reported a 20% mortality reduction with prostate-specific antigen (PSA) screening. However, they estimated a number needed to screen (NNS) of 1,410 and a number needed to treat (NNT) of 48 to prevent one prostate cancer death at 9 years. Although NNS and NNT are useful statistics to assess the benefits and harms of an intervention, in a survival study setting such as the ERSPC, NNS and NNT are time specific, and reporting values at one time point may lead to misinterpretation of results. Our objective was to re-examine the effect of varying follow-up times on NNS and NNT using data extrapolated from the ERSPC report. MATERIALS AND
methodsOn the basis of published ERSPC data, we modeled the cumulative hazard function using a piecewise exponential model, assuming a constant hazard of 0.0002 for the screening and control groups for years 1 to 7 of the trial and different constant rates of 0.00062 and 0.00102 for the screening and control groups, respectively, for years 8 to 12. Annualized cancer detection and drop-out rates were also approximated based on the observed number of individuals at risk in published ERSPC data.
resultsAccording to our model, the NNS and NNT at 9 years were 1,254 and 43, respectively. Subsequently, NNS decreased from 837 at year 10 to 503 at year 12, and NNT decreased from 29 to 18.
conclusionDespite the seemingly simplistic nature of estimating NNT, there is widespread misunderstanding of its pitfalls. With additional follow-up in the ERSPC, if the mortality difference continues to grow, the NNT to save a life with PSA screening will decrease.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.