RT Journal Article
T1 Absolute effect of prostate cancer screening: balance of benefits and harms by center within the european randomized study of prostate cancer screening.
A1 Auvinen, A
A1 Luján Galán, Marcos
A1 Hugosson, J
AB Purpose: The balance of benefits and harms in prostate cancer screening has not been sufficiently characterized. We related indicators of mortality reduction and overdetection by center within the European Randomized Study of Prostate Cancer Screening (ERSPC).Experimental design: We analyzed the absolute mortality reduction expressed as number needed to invite (NNI = 1/absolute risk reduction; indicating how many men had to be randomized to screening arm to avert a prostate cancer death) for screening and the absolute excess of prostate cancer detection as number needed for overdetection (NNO = 1/absolute excess incidence; indicating the number of men invited per additional prostate cancer case), and compared their relationship across the seven ERSPC centers.Results: Both absolute mortality reduction (NNI) and absolute overdetection (NNO) varied widely between the centers: NNI, 200-7,000 and NNO, 16-69. Extent of overdiagnosis and mortality reduction was closely associated [correlation coefficient, r = 0.76; weighted linear regression coefficient, β = 33; 95% confidence interval (CI), 5-62; R(2) = 0.72]. For an averted prostate cancer death at 13 years of follow-up, 12 to 36 excess cases had to be detected in various centers.Conclusions: The differences between the ERSPC centers likely reflect variations in prostate cancer incidence and mortality, as well as in screening protocol and performance. The strong interrelation between the benefits and harms suggests that efforts to maximize the mortality effect are bound to increase overdiagnosis and might be improved by focusing on high-risk populations. The optimal balance between screening intensity and risk of overdiagnosis remains unclear.
PB American Association for Cancer Research Journals
SN 1078-0432
YR 2015
FD 2015-08-19
LK https://hdl.handle.net/20.500.14352/116494
UL https://hdl.handle.net/20.500.14352/116494
LA eng
NO Auvinen A, Moss SM, Tammela TL, Taari K, Roobol MJ, Schröder FH, Bangma CH, Carlsson S, Aus G, Zappa M, Puliti D, Denis LJ, Nelen V, Kwiatkowski M, Randazzo M, Paez A, Lujan M, Hugosson J. Absolute Effect of Prostate Cancer Screening: Balance of Benefits and Harms by Center within the European Randomized Study of Prostate Cancer Screening. Clin Cancer Res. 2016 Jan 1;22(1):243-9. doi: 10.1158/1078-0432.CCR-15-0941. Epub 2015 Aug 19. Erratum in: Clin Cancer Res. 2016 Jul 15;22(14):3702. doi: 10.1158/1078-0432.CCR-16-1195. PMID: 26289069; PMCID: PMC4951205.
DS Docta Complutense
RD 11 abr 2025