Evidence map›Paper›PMID 33563084›Full record

ArticleJournal of medical screening2021

Impact of cancer screening on metastasis: A prostate cancer case study.

Jane Lange, Sebastiaan Remmers, Roman Gulati, Anna Bill-Axelson, Jan-Erik Johansson, Maciej Kwiatkowski, Anssi Auvinen, Jonas Hugosson, Jim C Hu, Monique J Roobol and 2 more

Open access · greenAbstract read
In one paragraph

Article in Journal of medical screening, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact, top 98% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 8 institutions in 5 countries.

Jane LangeDivision of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Sebastiaan RemmersDepartment of Urology, Erasmus University Medical Centre, Rotterdam, the Netherlands.ORCID 0000-0001-9530-6448
Roman GulatiDivision of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Anna Bill-AxelsonDepartment of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Jan-Erik JohanssonDepartment of Urology, The School of Health and Medical Sciences Örebro, Örebro, Sweden.
Maciej KwiatkowskiDepartment of Urology, Cantonal Hospital Aarau, Aarau, Switzerland.ORCID 0000-0002-8853-4554
Anssi AuvinenFaculty of Social Sciences, Tampere University, Tampere, Finland.
Jonas HugossonDepartment of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Jim C HuDepartment of Urology, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA.
Monique J RoobolDepartment of Urology, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Sigrid V CarlssonDepartment of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Ruth EtzioniDivision of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.ORCID 0000-0002-9164-6370
Fred Hutch Cancer Center · USMemorial Sloan Kettering Cancer Center · USNewYork–Presbyterian Hospital · USÖrebro University · SETampere University · FIUniversity of Basel · CHUniversity of Gothenburg · SEUppsala University · SE

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
SPORE In Prostate CancerP50CA092629 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI JAMES A EASTHAM · 2001 to 2026
$63.0M
Modeling Precision Interventions for Prostate Cancer ControlU01CA253915 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI ETZIONI, RUTH D, TSODIKOV, ALEXANDER · 2020 to 2025
$6.5M
Modeling to Improve Prostate Cancer Outcomes Across Diverse PopulationsU01CA199338 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI DE KONING, HARRY J, ETZIONI, RUTH D · 2015 to 2019
$5.2M
Statistical modeling to support population and translational cancer researchR50CA221836 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI Roman Gulati · 2017 to 2026
$2.0M
Improving shared decision making in cancer screeningK22CA234400 · NCI · SLOAN-KETTERING INST CAN RESEARCH · PI CARLSSON, SIGRID · 2019 to 2021
$621k
NCI NIH HHS K22 CA234400NCI NIH HHS P30 CA008748NCI NIH HHS P50 CA092629NCI NIH HHS R50 CA221836NCI NIH HHS U01 CA199338NCI NIH HHS U01 CA253915
6 · The paper itself

Abstract

backgroundTrials of cancer screening present results in terms of deaths prevented, but metastasis is also a key endpoint that screening seeks to prevent. We developed a framework for projecting overall (de novo and progressive) metastases prevented in a screening trial using prostate cancer screening as a case study.

methodsMechanistic simulation model in which screening shifts a fraction of cases that would be metastatic at diagnosis to being non-metastatic. This shift increases the incidence of non-overdiagnosed, organ-confined cases. We use estimates of the risk of metastatic progression for these cases to project how many progress to metastasis after diagnosis and tally the projected de novo and progressive metastatic cases with and without screening. We use data on stage shift from the European Randomized Study of Screening for Prostate Cancer (ERSPC) and data on the risk of metastatic progression from the Scandinavian Prostate Cancer Group-4 trial. We estimate the relative risk and absolute risk reductions in metastatic disease at diagnosis and compare these with reductions in overall metastases.

resultsAssuming no effect of screening beyond initial stage shift at diagnosis, the model projects a 43% reduction in metastasis at diagnosis but a 22% reduction in the cumulative probability of metastasis over 12 years in favor of screening. These results are consistent with the empirical findings from the ERSPC.

conclusionAny reduction in metastatic disease at diagnosis under screening is likely to be an overly optimistic predictor of the impact of screening on overall metastasis and disease-specific mortality.

Indexed as

Early Detection of CancerProstatic NeoplasmsHumansIncidenceMaleMass ScreeningProstate-Specific AntigenProstate-Specific AntigenEuropean Randomized Study of Screening for Prostate CancermetastasisProstate cancerscreeningsimulation model

Identifiers

PMID33563084
PMCPMC8349931
OpenAlexW3126437174

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.