OBJECTIVES: To document the extent of prostate-specific antigen (PSA)-testing in the general population at Getafe (Spain) outside our prostate cancer (PC) screening program, and to check its performance in terms of PC detection. METHODS:A total of 5371 PSA-test records (1997-1999) were reviewed and testing rates estimated per 1000 person-years. The extent of patient referral (men referred to our facilities) was calculated adjusting for PSA levels. To approach the performance of testing in the general population, our PC screening program acted as a standard for comparison. The probability of missing one PC in the general population was estimated in terms of number of men necessary to screen (NNS). Calculations were made adjusting for PSA levels. RESULTS:PSA-testing rate in the general population was 21.6/1000 person-years. In the age-group 55-69 years, this rate was 86.8/1000 (152.6 in men >70 years). Referral rates were 67.9 and 39.5% for men with PSA 4-10 and >10 ng/ml, respectively. Overall PC detection rate was 1.76%. Detection rates for PSA 4-10 and >10 ng/ml were 4.66 and 12.94%, respectively. When compared with the performance of the screening program, for every 17 men with a PSA in the range 4-10 ng/ml one cancer was missed (95% confidence interval (CI), 9-580). Similarly, one cancer was lost for every four men with a PSA >10 ng/ml (95% CI, 2-8). CONCLUSIONS: The extent of opportunistic testing in our setting is very high, particularly in the older age groups. Opportunistic screening renders PC detection rates lower than expected for every PSA level and cannot be encouraged.
RCT Entities:
OBJECTIVES: To document the extent of prostate-specific antigen (PSA)-testing in the general population at Getafe (Spain) outside our prostate cancer (PC) screening program, and to check its performance in terms of PC detection. METHODS: A total of 5371 PSA-test records (1997-1999) were reviewed and testing rates estimated per 1000 person-years. The extent of patient referral (men referred to our facilities) was calculated adjusting for PSA levels. To approach the performance of testing in the general population, our PC screening program acted as a standard for comparison. The probability of missing one PC in the general population was estimated in terms of number of men necessary to screen (NNS). Calculations were made adjusting for PSA levels. RESULTS:PSA-testing rate in the general population was 21.6/1000 person-years. In the age-group 55-69 years, this rate was 86.8/1000 (152.6 in men >70 years). Referral rates were 67.9 and 39.5% for men with PSA 4-10 and >10 ng/ml, respectively. Overall PC detection rate was 1.76%. Detection rates for PSA 4-10 and >10 ng/ml were 4.66 and 12.94%, respectively. When compared with the performance of the screening program, for every 17 men with a PSA in the range 4-10 ng/ml one cancer was missed (95% confidence interval (CI), 9-580). Similarly, one cancer was lost for every four men with a PSA >10 ng/ml (95% CI, 2-8). CONCLUSIONS: The extent of opportunistic testing in our setting is very high, particularly in the older age groups. Opportunistic screening renders PC detection rates lower than expected for every PSA level and cannot be encouraged.
Authors: Ruth C Travis; Naomi E Allen; Paul N Appleby; Alison Price; Rudolf Kaaks; Jenny Chang-Claude; Heiner Boeing; Krasimira Aleksandrova; Anne Tjønneland; Nina Føns Johnsen; Kim Overvad; J Ramón Quirós; Carlos A González; Esther Molina-Montes; Maria José Sánchez; Nerea Larrañaga; José María Huerta Castaño; Eva Ardanaz; Kay-Tee Khaw; Nick Wareham; Antonia Trichopoulou; Tina Karapetyan; Snorri Bjorn Rafnsson; Domenico Palli; Vittorio Krogh; Rosario Tumino; Paolo Vineis; H Bas Bueno-de-Mesquita; Pär Stattin; Mattias Johansson; Veronika Fedirko; Teresa Norat; Afshan Siddiq; Elio Riboli; Timothy J Key Journal: Cancer Causes Control Date: 2012-05-22 Impact factor: 2.506
Authors: N E Allen; T J Key; P N Appleby; R C Travis; A W Roddam; A Tjønneland; N F Johnsen; K Overvad; J Linseisen; S Rohrmann; H Boeing; T Pischon; H B Bueno-de-Mesquita; L Kiemeney; G Tagliabue; D Palli; P Vineis; R Tumino; A Trichopoulou; C Kassapa; D Trichopoulos; E Ardanaz; N Larrañaga; M-J Tormo; C A González; J R Quirós; M-J Sánchez; S Bingham; K-T Khaw; J Manjer; G Berglund; P Stattin; G Hallmans; N Slimani; P Ferrari; S Rinaldi; E Riboli Journal: Br J Cancer Date: 2008-04-01 Impact factor: 7.640