scholarly journals Design-corrected variation by centre in mortality reduction in the ERSPC randomised prostate cancer screening trial

2016 ◽  
Vol 24 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Matti Hakama ◽  
Sue M Moss ◽  
Ulf-Hakan Stenman ◽  
Monique J Roobol ◽  
Marco Zappa ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Ratio ◽  
Cancer Mortality ◽  
Prostate Cancer Screening ◽  
Target Population ◽  
Mortality Reduction ◽  
Randomised Study ◽  
Prostate Cancer Mortality ◽  
Specific Variation

Objectives To calculate design-corrected estimates of the effect of screening on prostate cancer mortality by centre in the European Randomised Study of Screening for Prostate Cancer (ERSPC). Setting The ERSPC has shown a 21% reduction in prostate cancer mortality in men invited to screening with follow-up truncated at 13 years. Centres either used pre-consent randomisation (effectiveness design) or post-consent randomisation (efficacy design). Methods In six centres (three effectiveness design, three efficacy design) with follow-up until the end of 2010, or maximum 13 years, the effect of screening was estimated as both effectiveness (mortality reduction in the target population) and efficacy (reduction in those actually screened). Results The overall crude prostate cancer mortality risk ratio in the intervention arm vs control arm for the six centres was 0.79 ranging from a 14% increase to a 38% reduction. The risk ratio was 0.85 in centres with effectiveness design and 0.73 in those with efficacy design. After correcting for design, overall efficacy was 27%, 24% in pre-consent and 29% in post-consent centres, ranging between a 12% increase and a 52% reduction. Conclusion The estimated overall effect of screening in attenders (efficacy) was a 27% reduction in prostate cancer mortality at 13 years’ follow-up. The variation in efficacy between centres was greater than the range in risk ratio without correction for design. The centre-specific variation in the mortality reduction could not be accounted for by the randomisation method.

Prostate cancer screening, treatment, and outcomes— A population-based study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10017-10017
Author(s):  
G. L. Lu-Yao ◽  
P. C. Albertsen ◽  
J. L. Stanford ◽  
T. A. Stukel ◽  
E. S. Walker-Corkery ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Cancer Mortality ◽  
Prostate Cancer Screening ◽  
Population Based ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Prostate Cancer Mortality

10017 Background: It remains unknown whether more intense prostate cancer screening and treatment reduces prostate cancer mortality. We describe the experiences of two population-based cohorts with 15-years follow-up (1987–2001) to address the following questions: 1) does more intense screening and treatment for prostate cancer lead to lower mortality in community settings, and 2) do older men (age ≥75–79) benefit from more intense prostate cancer screening and treatment. Methods: Population-based cohort study consisting of white male Medicare beneficiaries who resided in the regions covered by the Seattle (N=88,863) and Connecticut (N=114,785) cancer registries. Inclusion criteria are age 65–79 and free of prostate cancer on January 1, 1987. All study subjects were followed through death or the end of 2001. The main outcomes are rates of screening for prostate cancer, treatment with radical prostatectomy, external beam radiotherapy, and prostate cancer specific mortality. Results: Between 1987 and 1990, compared to men in Connecticut, men in the Seattle region were 5.4 times (95% C.I. 4.8 - 6.1) more likely to undergo PSA testing, 2.2 times (95% C.I. 1.8 - 2.7) more likely to under go prostate biopsy, 5.9 times (95% C.I. 5.5 - 6.9) more likely to have radial prostatectomy, and 2.3 times (95% C.I. 2.2 - 2.5) more likely to have external beam radiation. The cumulative risk of radical prostatectomy or external beam radiation reached 9.1% in the Seattle cohort and 5.0% in the Connecticut cohort in 2001. After 15 years of follow-up, prostate cancer mortality rates were similar for subjects in the two study regions (hazard ratio of Seattle to CT: 1.01, 95% C.I. 0.93 - 1.09). For older men (aged 75–79 in 1987), however, the prostate cancer mortality rate was slightly higher in the Seattle than the Connecticut cohort (hazard ratio: 1.16, 95% C.I. 1.02 - 1.32). Conclusion: More intense screening for prostate cancer, surgery or radiation among a cohort of Medicare beneficiaries in the Seattle area compared with their counterparts in Connecticut has not lead to significantly lower mortality from prostate cancer over 15 years of follow-up. No significant financial relationships to disclose.

scholarly journals Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up

The Lancet ◽  
2014 ◽  
Vol 384 (9959) ◽  
pp. 2027-2035 ◽  
Author(s):  
Fritz H Schröder ◽  
Jonas Hugosson ◽  
Monique J Roobol ◽  
Teuvo L J Tammela ◽  
Marco Zappa ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Mortality ◽  
Randomised Study ◽  
Prostate Cancer Mortality

435: When is Decreased Prostate Cancer Mortality to be Expected Provided that Efficacious Prostate Cancer Screening is Introduced?

2004 ◽  
Vol 171 (4S) ◽  
pp. 115-115
Author(s):  
Magnus Törnblom ◽  
Henry Eriksson ◽  
Stefan Franzen ◽  
Ove Gustafsson ◽  
Hans Lilja ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Cancer Mortality ◽  
Prostate Cancer Screening ◽  
Prostate Cancer Mortality

scholarly journals Development and Validation of an Interpretable Artificial Intelligence Model to Predict 10-Year Prostate Cancer Mortality

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 3064
Author(s):  
Jean-Emmanuel Bibault ◽  
Steven Hancock ◽  
Mark K. Buyyounouski ◽  
Hilary Bagshaw ◽  
John T. Leppert ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Treatment ◽  
Cancer Mortality ◽  
Treatment Strategies ◽  
Gradient Boosting ◽  
Prostate Cancer Treatment ◽  
Prospective Data ◽  
Prostate Cancer Mortality ◽  
Development And Validation

Prostate cancer treatment strategies are guided by risk-stratification. This stratification can be difficult in some patients with known comorbidities. New models are needed to guide strategies and determine which patients are at risk of prostate cancer mortality. This article presents a gradient-boosting model to predict the risk of prostate cancer mortality within 10 years after a cancer diagnosis, and to provide an interpretable prediction. This work uses prospective data from the PLCO Cancer Screening and selected patients who were diagnosed with prostate cancer. During follow-up, 8776 patients were diagnosed with prostate cancer. The dataset was randomly split into a training (n = 7021) and testing (n = 1755) dataset. Accuracy was 0.98 (±0.01), and the area under the receiver operating characteristic was 0.80 (±0.04). This model can be used to support informed decision-making in prostate cancer treatment. AI interpretability provides a novel understanding of the predictions to the users.

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