Trial reportBMC medicine2014
Empirical estimates of prostate cancer overdiagnosis by age and prostate-specific antigen.
Trial report in BMC medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
70 citing papers in PubMed, 7 syntheses or guidelines pooled it, 119 citations in OpenAlex.
- The Benefits and Harms of Screening for Prostate Cancer in Adults Aged 18 Years and Older: A Systematic Review.Current oncology (Toronto, Ont.) · 2026Pooled it
- The research progress on diagnostic indicators related to prostate-specific antigen gray-zone prostate cancer.BMC cancer · 2025Pooled it
- Early Detection of Prostate Cancer: AUA/SUO Guideline Part I: Prostate Cancer Screening.The Journal of urology · 2023Guideline
- Genetically adjusted PSA levels for prostate cancer screening.Nature medicine · 2023Pooled it
- Application and optimization of prostate-specific antigen screening strategy in the diagnosis of prostate cancer: a systematic review.Frontiers in oncology · 2023Pooled it
- The Memorial Sloan Kettering Cancer Center Recommendations for Prostate Cancer Screening.Urology · 2016Guideline
- CLINICAL EVALUATION OF AN EPIGENETIC ASSAY TO PREDICT MISSED CANCER IN PROSTATE BIOPSY SPECIMENS.Transactions of the American Clinical and Climatological Association · 2016Pooled it
- Evaluating the Impact of Age on Prostate Cancer Overdiagnosis Using Long-Term Follow-Up From the CAP Randomised Trial.International journal of cancer · 2026Trial
- Results from 22 years of Followup in the Göteborg Randomized Population-Based Prostate Cancer Screening Trial.The Journal of urology · 2022Trial
- Trends and Patterns in Prostate Cancer Diagnostics During the Era of MRI Implementation - Real-world Evidence From a Population-based Study in the Stockholm Region, Sweden 2010-2023.European urology open science · 2026Article
- Effect of implementing population-based prostate-specific antigen screening on testing rates and prostate cancer overdiagnosis in England: a statistical modelling study.medRxiv : the preprint server for health sciences · 2026Article
- Opportunities to Avoid Invasive Cancer by Diagnosis and Interception of Preneoplastic Lesions and Cancer Risk Conditions.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Article
- Prostate-specific antigen levels at age 60 years and lifetime risk of lethal prostate cancer.Journal of the National Cancer Institute · 2025Article
- Influence of life expectancy on shared decision-making for prostate cancer screening.Cancer causes & control : CCC · 2025Article
- Prostate specific antigen retesting intervals and trends in England: population based cohort study.BMJ (Clinical research ed.) · 2025Article
- Which patients with negative PSMA-PET imaging can safely avoid biopsy for prostate cancer? a novel step towards PSMA-based biopsy-free strategy.European journal of nuclear medicine and molecular imaging · 2025Article
- Machine learning based on automated 3D radiomics features to classify prostate cancer in patients with prostate-specific antigen levels of 4-10 ng/mL.Translational andrology and urology · 2025Article
- Trends in stage-specific prostate cancer incidence by neighborhood socioeconomic status.JNCI cancer spectrum · 2025Article
- Prostate Cancer Mortality in Men Aged 70 Years Who Recently Underwent Prostate-Specific Antigen Screening.JAMA network open · 2025Article
- Impact of patients' age and comorbidities on prostate cancer overdiagnosis in clinical practice.PloS one · 2025Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundProstate cancer screening depends on a careful balance of benefits, in terms of reduced prostate cancer mortality, and harms, in terms of overdiagnosis and overtreatment. We aimed to estimate the effect on overdiagnosis of restricting prostate specific antigen (PSA) testing by age and baseline PSA.
methodsEstimates of the effects of age on overdiagnosis were based on population based incidence data from the US Surveillance, Epidemiology and End Results database. To investigate the relationship between PSA and overdiagnosis, we used two separate cohorts subject to PSA testing in clinical trials (n = 1,577 and n = 1,197) and a population-based cohort of Swedish men not subject to PSA-screening followed for 25 years (n = 1,162).
resultsIf PSA testing had been restricted to younger men, the number of excess cases associated with the introduction of PSA in the US would have been reduced by 85%, 68% and 42% for age cut-offs of 60, 65 and 70, respectively. The risk that a man with screen-detected cancer at age 60 would not subsequently lead to prostate cancer morbidity or mortality decreased exponentially as PSA approached conventional biopsy thresholds. For PSAs below 1 ng/ml, the risk of a positive biopsy is 65 (95% CI 18.2, 72.9) times greater than subsequent prostate cancer mortality.
conclusionsProstate cancer overdiagnosis has a strong relationship to age and PSA level. Restricting screening in men over 60 to those with PSA above median (>1 ng/ml) and screening men over 70 only in selected circumstances would importantly reduce overdiagnosis and change the ratio of benefits to harms of PSA-screening.
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What OpenQuestion holds
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.