Abstract
Objective: Lead-time in prostate cancer screening was estimated using data from the Finnish randomized, population-based trial. Methods: Lead-time was defined as the duration of follow-up needed to accrue the same expected number of incident prostate cancer cases in the absence of screening as detected in the initial screening round. Expected numbers were calculated using an age-cohort model. Results: Based on findings among 10,000 men screened in 1996–1997 with 292 screen-detected cancers, lead-time was estimated as approximately 5–7 years, depending on the reference rates used. This corresponds to a mean duration of the detectable preclinical phase (DPCP) of 10–14 years, given that the cancers were detected on average at the midpoint of the DPCP. Conclusions: The findings suggest that a screening interval substantially longer than the 2 years generally used for mammography screening is unlikely to cause a substantial loss of sensitivity. A long screening interval is further justified in order to diminish the extent of overdiagnosis, until mortality effects can be evaluated.
References
Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J, eds. (1997) Cancer Incidence in Five Continents, vol. VII. Publ. No 143. Lyon: International Agency for Research on Cancer.
Ross RK, Schottenfeld D (1996) Prostate cancer. In: Schottenfeld D, Fraumeni JF, eds. Cancer Epidemiology and Prevention, 2nd edn. New York: Oxford University Press, pp. 1180-1206.
Auvinen A, Rietbergen J, Gohagen J, Denis L, Schro¨ der F (1996) Prospective evaluation plan for randomized trials of prostate cancer screening. J Med Screening 3: 97-104.
Chen J S, Prorok PC (1983) Lead time estimation in a controlled screening program. Am J Epidemiol 118: 740-751.
Walter SD, Day NE (1983) Estimation of the duration of a preclinical disease state using screening data. Am J Epidemiol 118: 865-886.
Ma¨ a¨ tta¨ nen L, Auvinen A, Stenman U-H, et al. (1999) European randomized study of prostate cancer screening: first-year results of the Finnish trial. Br J Cancer 79: 1210-1214.
Teppo L, Pukkala E, Lehtonen M (1994) Data quality and quality control of a population-based cancer registry. Acta Oncol 33: 365-369.
Smith DS, Catalona WJ, Herschman JD (1996) Longitudinal screening for prostate cancer with prostate-specific antigen. JAMA 276: 1309-1315.
Mettlin CJ, Murphy GP, Babaian RJ, et al. (1997) Observations on the early detection of prostate cancer from the American Cancer Society National Prostate Cancer Detection Project. Cancer 80: 1814-1817.
Lodding P, Aus G, Bergdahl S, et al. (1998) Characteristics of screening detected prostate cancer in men 50 to 66 years old with 3 to 4 ng/ml. J Urol 159: 899-903.
Schro¨ der FH, Kranse R, Rietbergen J, Hoedemaeker R, Kirkels W (1999) The European Randomized Study of Screening for Prostate Cancer (ERSPC): an update. Members of the ERSPC, Section Rotterdam. Eur Urol 35: 539-543.
Chodak GW, Thisted RA, Gerber GS, et al. (1994) Results of conservative management of clinically localized prostate cancer. N Engl J Med 330: 242-248. 284 A. Auvinen et al.
Breslow N, Chan CW, Dhom G, et al. (1977) Latent carcinoma of prostate at autopsy in seven areas. Int J Cancer 20: 680-688.
Ries LAG, Eisner MP, Kosary CL, et al., eds (2001) SEER Cancer Statistics Review, 1973-1998. Bethesda, MD: National Cancer Institute.
Cancer Incidence in Finland 1997-1998 (2000). Helsinki: Cancer Society of Finland. Available also from http:/www.cancerregistry.fi/.
Stenman UH, Hakama M, Knekt P, Aromaa A, Teppo L, Leinonen J (1994). Serum concentrations of prostate specific antigen and its complex with alpha-1-antichymotrypsin before diagnosis of prostate cancer. Lancet 344: 1594-1598.
Whittemore AS, Keller JB, Betensky R (1991) Low-grade, latent prostate cancer volume: predictor of clinical incidence? J Natl Cancer Inst 83: 1231-1235.
Whittemore AS, Lele C, Friedman GD, et al. (1995) Prostatespecific antigen as predictor of prostate cancer in black men and white men. J Natl Cancer Inst 87: 354-360.
Morrell CH, Pearson JD, Carter HB, et al. (1995) Estimating unknown transition times using a piecewise nonlinear mixed effects model in men with prostate cancer. JAmStat Assoc 90: 45-53.
Etzioni R, Cha R, Feuer EJ, Davidov O (1998) Asymptomatic incidence and duration of prostate cancer. Am J Epidemiol 148: 775-785.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Auvinen, A., Määttänen, L., Stenman, UH. et al. Lead-time in prostate cancer screening (Finland). Cancer Causes Control 13, 279–285 (2002). https://doi.org/10.1023/A:1015040231402
Issue Date:
DOI: https://doi.org/10.1023/A:1015040231402