False-positive screening results in the Finnish prostate cancer screening trial
| Autor: | Teemu J. Murtola, Martti Ala-Opas, Tuomas P. Kilpeläinen, Anssi Auvinen, Paula Kujala, Liisa Määttänen, Teuvo L.J. Tammela, U.H. Stenman |
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| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
mass screening
Male Cancer Research medicine.medical_specialty Biopsy Population 030232 urology & nephrology Prostatic Hyperplasia randomised controlled trials law.invention 03 medical and health sciences Prostate cancer PSA 0302 clinical medicine Randomized controlled trial law Internal medicine Cancer screening Clinical Studies medicine Humans False Positive Reactions education Mass screening Early Detection of Cancer Finland Aged Gynecology education.field_of_study business.industry Prostate Prostatic Neoplasms Middle Aged Prostate-Specific Antigen medicine.disease 3. Good health Prostate-specific antigen Prostate cancer screening Oncology sensitivity and specificity 030220 oncology & carcinogenesis Relative risk business |
| Zdroj: | British Journal of Cancer |
| ISSN: | 1532-1827 0007-0920 |
| Popis: | Background: There is evidence that prostate cancer (PC) screening with prostate-specific antigen (PSA) serum test decreases PC mortality, but screening has adverse effects, such as a high false-positive (FP) rate. We investigated the proportion of FPs in a population-based randomised screening trial in Finland. Methods: Finland is the largest centre in the European Randomized Study of Screening for Prostate Cancer. We have completed three screening rounds with a 4-year screening interval (mean follow-up time 9.2 years) using a PSA cutoff level of 4.0 ng ml−1; in addition, men with PSA 3.0–3.9 and a positive auxiliary test were referred. An FP result was defined as a positive screening result without cancer in biopsy within 1 year from the screening test. Results: The proportion of FP screening results varied from 3.3 to 12.1% per round. Of the screened men, 12.5% had at least one FP during three rounds. The risk of next-round PC following an FP result was 12.3–19.7 vs 1.4–3.7% following a screen-negative result (depending on the screening round), risk ratio 3.6–9.9. More than half of the men with one FP result had another one at a subsequent screen. Men with an FP result were 1.5 to 2.0 times more likely to not participate in subsequent rounds compared with men with a normal screening result (21.6–29.6 vs 14.0–16.7%). Conclusion: An FP result is a common adverse effect of PC screening and affects at least every eighth man screened repeatedly, even when using a relatively high cutoff level. False-positive men constitute a special group that receives unnecessary interventions but may harbour missed cancers. New strategies are needed for risk stratification in PC screening to minimise the proportion of FP men. |
| Databáze: | OpenAIRE |
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