ArticleJournal of the National Cancer Institute2020
Lifetime Benefits and Harms of Prostate-Specific Antigen-Based Risk-Stratified Screening for Prostate Cancer.
Article in Journal of the National Cancer Institute, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 21 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
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Guideline of guidelines: a critical appraisal of the evidence for PSA retesting intervals.BJU international · 2025Pooled it
- Early Detection of Prostate Cancer: AUA/SUO Guideline Part I: Prostate Cancer Screening.The Journal of urology · 2023Guideline
- HRS Improves Active Surveillance for Prostate Cancer by Timely Identification of Progression.Academic radiology · 2025Trial
- Prostate cancer incidence in men with prostate-specific antigen below 3 ng/mL: The Finnish Randomized Study of Screening for Prostate Cancer.International journal of cancer · 2023Trial
- APOE ε2/ε3 is associated with multi-layered protection against prostate cancer in Chinese men.World journal of urology · 2026Article
- Efficacy endpoints of MRI-based prostate cancer screening: an epidemiological perspective.European radiology · 2026Article
- Lifetime Health and Economic Outcomes of Biparametric Magnetic Resonance Imaging as First-Line Screening for Prostate Cancer : A Decision Model Analysis.Annals of internal medicine · 2024Article
- Prostate cancer screening in African American men: a review of the evidence.Journal of the National Cancer Institute · 2024Review
- Racial disparities in prostate cancer mortality: a model-based decomposition of contributing factors.Journal of the National Cancer Institute. Monographs · 2023Article
- Urinary marker panels for aggressive prostate cancer detection.Scientific reports · 2022Article
- Redefining Age-Based Screening and Diagnostic Guidelines: An Opportunity for Biological Aging Clocks in Clinical Medicine?The lancet. Healthy longevity · 2022Article
- Evaluation of Prostate Cancer Screening Strategies in a Low-Resource, High-risk Population in the Bahamas.JAMA health forum · 2022Article
- Prediction of future risk of any and higher-grade prostate cancer based on the PLCO and SELECT trials.BMC urology · 2022Article
- Clarifying the Trade-Offs of Risk-Stratified Screening for Prostate Cancer: A Cost-Effectiveness Study.American journal of epidemiology · 2021Article
- Economic Evaluation of Urine-Based or Magnetic Resonance Imaging Reflex Tests in Men With Intermediate Prostate-Specific Antigen Levels in the United States.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2021Article
- When to Discuss Prostate Cancer Screening With Average-Risk Men.American journal of preventive medicine · 2021Article
- Cost-effectiveness of multiparametric magnetic resonance imaging and MRI-guided biopsy in a population-based prostate cancer screening setting using a micro-simulation model.Cancer medicine · 2021Article
- The comparative effectiveness of mpMRI and MRI-guided biopsy vs regular biopsy in a population-based PSA testing: a modeling study.Scientific reports · 2021Article
- Prostate Cancer Incidence 5 Years After US Preventive Services Task Force Recommendations Against Screening.Journal of the National Cancer Institute · 2021Article
- An Up-to-date Assessment of US Prostate Cancer Incidence Rates by Stage and Race: A Novel Approach Combining Multiple Imputation with Age and Delay Adjustment.European urology · 2021Observational
Corrections and comments
- Commented on by
- Erratum issuedErratum.2020
Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundStudies conducted in Swedish populations have shown that men with lowest prostate-specific antigen (PSA) levels at ages 44-50 years and 60 years have very low risk of future distant metastasis or death from prostate cancer. This study investigates benefits and harms of screening strategies stratified by PSA levels.
methodsPSA levels and diagnosis patterns from two microsimulation models of prostate cancer progression, detection, and mortality were compared against results of the Malmö Preventive Project, which stored serum and tracked subsequent prostate cancer diagnoses for 25 years. The models predicted the harms (tests and overdiagnoses) and benefits (lives saved and life-years gained) of PSA-stratified screening strategies compared with biennial screening from age 45 years to age 69 years.
resultsCompared with biennial screening for ages 45-69 years, lengthening screening intervals for men with PSA less than 1.0 ng/mL at age 45 years led to 46.8-47.0% fewer tests (range between models), 0.9-2.1% fewer overdiagnoses, and 3.1-3.8% fewer lives saved. Stopping screening when PSA was less than 1.0 ng/mL at age 60 years and older led to 12.8-16.0% fewer tests, 5.0-24.0% fewer overdiagnoses, and 5.0-13.1% fewer lives saved. Differences in model results can be partially explained by differences in assumptions about the link between PSA growth and the risk of disease progression.
conclusionRelative to a biennial screening strategy, PSA-stratified screening strategies investigated in this study substantially reduced the testing burden and modestly reduced overdiagnosis while preserving most lives saved. Further research is needed to clarify the link between PSA growth and disease progression.
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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.