| Titre : | Comparative efficiency of prostate-specific antigen screening strategies for prostate cancer detection. (2000) |
| Auteurs : | Kevin-S ROSS ; Hballentine CARTER ; Harry-A GUESS ; Jay-D PEARSON ; Department of Epidemiology. Merck Research Laboratories. Blue Bell. PA. USA ; Department of Epidemiology. University of North Carolina at Chapel Hill. USA ; Department of Urology. The Johns Hopkins University School of Medicine. James Buchanan Brady Urological Institute. Johns Hopkins Hospital. Baltimore. MD. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 284, n° 11, 2000) |
| Pagination : | 1399-1405 |
| Langues: | Anglais |
| Mots-clés : | Cancer ; Prostate ; Dépistage ; Homme ; Appareil urinaire [pathologie] |
| Résumé : | [BDSP. Notice produite par INIST R0xsWlrz. Diffusion soumise à autorisation]. Context Despite widespread use of serum prostate-specific antigen (PSA) testing to detect prostate cancer, the relative effectiveness of different PSA screening strategies is unknown. Objective To compare prostate cancer mortality, PSA testing rates, and biopsy rates using various PSA screening strategies, including the standard strategy of annually testing men aged 50 through 75 years. Design and Setting A Monte-Carlo simulation based on a Markov model was used to simulate the natural history of prostate cancer using different starting ages, testing intervals, and PSA thresholds for prostate biopsy. Age-specific PSA levels and prostate biopsy detection probabilities were determined from population data and surgical series. Main Outcome Measures Numbers of prevented prostate cancer deaths, PSA tests, and prostate biopsies per 1000 men aged 40 through 80 years, compared among 7 different strategies vs no screening. Results Compared with annual PSA testing beginning at age 50 years, the strategy of PSA testing at ages 40 and 45 years followed by biennial testing beginning at age 50 years was estimated to simultaneously reduce prostate cancer mortality and number of PSA tests and biopsies performed per 1000 men. Specifically, compared with no screening, the standard strategy prevents 3.2 deaths, with an additional 10500 PSA tests and 600 prostate biopsies, while the earlier but less frequent strategy prevents 3. (...) |
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