ArticleJournal of the National Cancer Institute2013
Effects of screening on radical prostatectomy efficacy: the prostate cancer intervention versus observation trial.
Article in Journal of the National Cancer Institute, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed.
- The association between urinary nitrate and prostate specific antigen without prostatic disease: a cohort study.BMC urology · 2025Article
- Transrectal versus transperineal prostate biopsy for cancer detection in patients with gray-zone prostate-specific antigen: a multicenter, real-world study.Asian journal of andrology · 2024Article
- Identification of novel serological autoantibodies in Chinese prostate cancer patients using high-throughput protein arrays.Cancer immunology, immunotherapy : CII · 2023Article
- Exploration of the Value of Combined UA, IL-6, and fPSA/tPSA in the Diagnosis of Prostate Cancer.Computational and mathematical methods in medicine · 2022Article
- Diagnosis of Prostate Cancer in Patients with Prostate-Specific Antigen (PSA) in the Gray Area: Construction of 2 Predictive Models.Medical science monitor : international medical journal of experimental and clinical research · 2021Article
- Using clinical parameters to predict prostate cancer and reduce the unnecessary biopsy among patients with PSA in the gray zone.Scientific reports · 2020Article
- Multivariable Models Incorporating Multiparametric Magnetic Resonance Imaging Efficiently Predict Results of Prostate Biopsy and Reduce Unnecessary Biopsy.Frontiers in oncology · 2020Article
- Long-Term Clinical Outcomes of Radical Prostatectomy versus Watchful Waiting in Localized Prostate Cancer Patients: A Systematic Review and Meta-Analysis.Iranian journal of public health · 2019Review
- Antisense transcription at the TRPM2 locus as a novel prognostic marker and therapeutic target in prostate cancer.Oncogene · 2015Article
- Measures of survival benefit in cancer drug development and their limitations.Urologic oncology · 2015Review
- Identification of pathologically insignificant prostate cancer is not accurate in unscreened men.British journal of cancer · 2014Article
- Imagine a world without cancer.BMC cancer · 2014Article
- Article
- Screening and efficacy of radical prostatectomy.Asian journal of andrology · 2013Article
- Future prospects in the diagnosis and management of localized prostate cancer.TheScientificWorldJournal · 2013Review
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6 authors.
Funding
Abstract
backgroundThe Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) trial showed that radical prostatectomy (RP) reduced prostate cancer deaths with an absolute mortality difference (AMD) between the RP and watchful waiting arms of 6.1% (95% confidence interval [CI] = 0.2% to 12.0%) after 15 years. In the United States, the Prostate Cancer Intervention Versus Observation Trial (PIVOT) produced an AMD of 3% (95% CI = -1.1% to 6.5%) after 12 years. It is not known whether a higher frequency of screen detection in PIVOT explains the lower AMD.
methodsWe assumed the SPCG-4 trial represents RP efficacy and prostate cancer survival in an unscreened population. Given the fraction of screen-detected prostate cancers in PIVOT, we adjusted prostate cancer survival using published estimates of overdiagnosis and lead time to project the effect of screen detection on disease-specific deaths.
resultsOn the basis of published estimates, we assumed that 32% of screen-detected cancers were overdiagnosed and a mean lead time among non-overdiagnosed cancers of 7.7 years. When we adjusted prostate cancer survival for the 76% of case patients in PIVOT who were screen detected, we projected that the AMD after 12 years would be 2.0% (95% CI = -1.6% to 5.6%) based on variation in published estimates of overdiagnosis and mean lead time in the United States.
conclusionsIf RP efficacy and prostate cancer survival in the absence of screening are similar to that in the SPCG-4 trial, then overdiagnosis and lead time largely explain the lower AMD in PIVOT. If these artifacts of screening are the correct explanation, then there is a subset of case subjects that should not be treated with RP, and identifying this subset should lead to a clearer understanding of the benefit of RP in the remaining cases.
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