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- Title
Quantifying the role of PSA screening in the US prostate cancer mortality decline.
- Authors
Ruth Etzioni; Angela Mariotto; Seth Falcon; Kent Karnofski; Roman Gulati; David Penson; Eric Feuer
- Abstract
Abstract Objective  To quantify the plausible contribution of prostate-specific antigen (PSA) screening to the nearly 30% decline in the US prostate cancer mortality rate observed during the 1990s. Methods  Two mathematical modeling teams of the US National Cancer Instituteâs Cancer Intervention and Surveillance Modeling Network independently projected disease mortality in the absence and presence of PSA screening. Both teams relied on Surveillance, Epidemiology, and End Results (SEER) registry data for disease incidence, used common estimates of PSA screening rates, and assumed that screening, by shifting disease from distant to local-regional clinical stage, confers a corresponding improvement in disease-specific survival. Results  The teams projected similar mortality increases in the absence of screening and decreases in the presence of screening after 1985. By 2000, the models projected that 45% (Fred Hutchinson Cancer Research Center) to 70% (University of Michigan) of the observed decline in prostate cancer mortality could be plausibly attributed to the stage shift induced by screening. Conclusions  PSA screening may account for much, but not all, of the observed drop in prostate cancer mortality. Other factors, such as changing treatment practices, may also have played a role in improving prostate cancer outcomes.
- Publication
Cancer Causes & Control, 2008, Vol 19, Issue 2, p175
- ISSN
0957-5243
- Publication type
Academic Journal
- DOI
10.1007/s10552-007-9083-8