Expected population impacts of discontinued prostate‐specific antigen screening

摘要: © 2014 American Cancer Society. BACKGROUND: Prostate-specific antigen (PSA) screening for prostate cancer has high risks of overdiagnosis, particularly among older men, and reports from trials indicate that it saves few lives after 11 to 13 years follow-up. New clinical guidelines recommend against PSA all men or aged >70 years, but, the authors' knowledge, expected population effects these have not been studied date. METHODS: Two models natural history diagnosis were previously developed using reconstructed patterns incidence in United States. Assuming a survival benefit consistent with trials, authors used predict mortality rates period 2013 through 2025 under continued discontinued years. RESULTS: The predicted continuation recent will overdiagnose 710,000 1,120,000 (range between models) but avoid 36,000 57,000 deaths over 2025. Discontinued eliminated 100% overdiagnoses failed prevent avoidable deaths. Continued <70 64% 66% 36% 39% CONCLUSIONS: Discontinuing may generate many Continuing could greater than one-half while dramatically reducing compared ages.