Quantifying the role of PSA screening in the US prostate cancer mortality decline

Ruth Etzioni, Alex Tsodikov, Angela Mariotto, Aniko Szabo, Seth Falcon, Jake Wegelin, Dante Ditommaso, Kent Karnofski, Roman Gulati, David F. Penson, Eric Feuer

Research output: Contribution to journalArticle

241 Citations (Scopus)

Abstract

Objective: To quantify the plausible contribution of prostate-specific antigen (PSA) screening to the nearly 30% decline in the US prostate cancer mortality rate observed during the 1990s. Methods: Two mathematical modeling teams of the US National Cancer Institute's Cancer Intervention and Surveillance Modeling Network independently projected disease mortality in the absence and presence of PSA screening. Both teams relied on Surveillance, Epidemiology, and End Results (SEER) registry data for disease incidence, used common estimates of PSA screening rates, and assumed that screening, by shifting disease from distant to local-regional clinical stage, confers a corresponding improvement in disease-specific survival. Results: The teams projected similar mortality increases in the absence of screening and decreases in the presence of screening after 1985. By 2000, the models projected that 45% (Fred Hutchinson Cancer Research Center) to 70% (University of Michigan) of the observed decline in prostate cancer mortality could be plausibly attributed to the stage shift induced by screening. Conclusions: PSA screening may account for much, but not all, of the observed drop in prostate cancer mortality. Other factors, such as changing treatment practices, may also have played a role in improving prostate cancer outcomes.

Original languageEnglish (US)
Pages (from-to)175-181
Number of pages7
JournalCancer Causes and Control
Volume19
Issue number2
DOIs
StatePublished - Mar 1 2008
Externally publishedYes

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Prostate-Specific Antigen
Prostatic Neoplasms
Mortality
National Cancer Institute (U.S.)
Registries
Neoplasms
Epidemiology
Incidence
Research

Keywords

  • Computer simulation
  • Prostate cancer
  • Prostate-specific antigen
  • Public health

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Etzioni, R., Tsodikov, A., Mariotto, A., Szabo, A., Falcon, S., Wegelin, J., ... Feuer, E. (2008). Quantifying the role of PSA screening in the US prostate cancer mortality decline. Cancer Causes and Control, 19(2), 175-181. https://doi.org/10.1007/s10552-007-9083-8

Quantifying the role of PSA screening in the US prostate cancer mortality decline. / Etzioni, Ruth; Tsodikov, Alex; Mariotto, Angela; Szabo, Aniko; Falcon, Seth; Wegelin, Jake; Ditommaso, Dante; Karnofski, Kent; Gulati, Roman; Penson, David F.; Feuer, Eric.

In: Cancer Causes and Control, Vol. 19, No. 2, 01.03.2008, p. 175-181.

Research output: Contribution to journalArticle

Etzioni, R, Tsodikov, A, Mariotto, A, Szabo, A, Falcon, S, Wegelin, J, Ditommaso, D, Karnofski, K, Gulati, R, Penson, DF & Feuer, E 2008, 'Quantifying the role of PSA screening in the US prostate cancer mortality decline', Cancer Causes and Control, vol. 19, no. 2, pp. 175-181. https://doi.org/10.1007/s10552-007-9083-8
Etzioni R, Tsodikov A, Mariotto A, Szabo A, Falcon S, Wegelin J et al. Quantifying the role of PSA screening in the US prostate cancer mortality decline. Cancer Causes and Control. 2008 Mar 1;19(2):175-181. https://doi.org/10.1007/s10552-007-9083-8
Etzioni, Ruth ; Tsodikov, Alex ; Mariotto, Angela ; Szabo, Aniko ; Falcon, Seth ; Wegelin, Jake ; Ditommaso, Dante ; Karnofski, Kent ; Gulati, Roman ; Penson, David F. ; Feuer, Eric. / Quantifying the role of PSA screening in the US prostate cancer mortality decline. In: Cancer Causes and Control. 2008 ; Vol. 19, No. 2. pp. 175-181.
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