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Previous studies have shown that men with low PSA levels (<1.0 ng/mL) at ages 44 to 60 have very low risk of future prostate cancer. A study published this week in JNCI: Journal of the National Cancer Institute by Heijnsdijk and colleagues investigated benefits and harms of screening strategies associated with lengthening the screening interval when PSA is below 1.0 ng/mL at ages 45 or 50 or discontinuing screening when PSA is below 1.0 ng/mL at age 60.
Using statistical modeling techniques, they predicted the harms (measured in tests and overdiagnoses) and benefits (measured in lives saved and life-years gained) of PSA-stratified screening strategies versus the traditionally recommended screening for men between 45 and 69 every other year.
The models projected that screening 10,000 men ages 45 to 69 every other year would require more than 110,000 screens and result in up to 348 overdiagnoses. They found that lengthening the screening interval from two to eight years would result in a decrease of overdiagnosis by 5- 24%, and only 3.1 to 3.8% fewer lives saved.
Additionally the models predicted that discontinuing screening at age 60 for everyone would greatly reduce overdiagnoses (by 79-82%) but would save substantially fewer lives compared to screening until age 69.
This study shows the power of comparative modeling: by using two models with different underlying assumptions, we can identify uncertainty around the outcomes." Eveline Heijnsdijk, PhD., lead author Source:
Oxford University Press USA Journal reference:
Heijnsdijk, E.A.M., et al. (2020) Lifetime benefits and harms of PSA-based risk screening for prostate cancer. JNCI: Journal of the National Cancer Institute . doi.org/10.1093/jnci/djaa001 .
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