To be screened or not to be screened? Modeling the consequences of PSA screening for the individual.
To be screened or not to be screened? Modeling the consequences of PSA screening for the individual.
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DOI：
10.1038/bjc.2012.317
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发表时间：
2012-08-21
影响因子：
8.8
通讯作者：
de Koning, H. J.
中科院分区：
文献类型：
--
作者：
Wever, E. M.;Hugosson, J.;Heijnsdijk, E. A. M.;Bangma, C. H.;Draisma, G.;de Koning, H. J.
前列腺特异性抗原（PSA）筛查可降低前列腺癌死亡率，但可能导致诊断和治疗不及时，导致过检和过度治疗。我们估计了PSA筛查对决定是否进行筛查的个体的益处和不良影响。使用微观模拟模型，我们估计了前列腺癌诊断和死亡的终生概率，总体预期寿命和预期诊断时间，无论是否进行筛查。我们计算了由于前列腺癌诊断和治疗而导致的预期生活质量损失，从而决定支持筛查。接受筛查的男性的预期寿命增加了0.08年，但他们的预期诊断时间减少了1.53年。在接受筛查的男性中，0.99%的人平均增加了8.08个生命年，17.43%的人预计诊断时间减少了8.78个生命年。这些数字意味着，由于诊断和治疗导致的预期生活质量损失不应超过4.8%，筛查才能对质量调整后的预期寿命产生积极影响。接受筛查的决定应取决于个人喜好。如果对那些更愿意接受治疗副作用的男性进行筛查，可能会减少筛查的负面影响。
Screening with prostate-specific antigen (PSA) can reduce prostate cancer mortality, but may advance diagnosis and treatment in time and lead to overdetection and overtreatment. We estimated benefits and adverse effects of PSA screening for individuals who are deciding whether or not to be screened. Using a microsimulation model, we estimated lifetime probabilities of prostate cancer diagnosis and death, overall life expectancy and expected time to diagnosis, both with and without screening. We calculated anticipated loss in quality of life due to prostate cancer diagnosis and treatment that would be acceptable to decide in favour of screening. Men who were screened had a gain in life expectancy of 0.08 years but their expected time to diagnosis decreased by 1.53 life-years. Of the screened men, 0.99% gained on average 8.08 life-years and for 17.43% expected time to diagnosis decreased by 8.78 life-years. These figures imply that the anticipated loss in quality of life owing to diagnosis and treatment should not exceed 4.8%, for screening to have a positive effect on quality-adjusted life expectancy. The decision to be screened should depend on personal preferences. The negative impact of screening might be reduced by screening men who are more willing to accept the side effects from treatment.
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影响因子：
8.8
作者：
Heijnsdijk, E. A. M.;der Kinderen, A.;Wever, E. M.;Draisma, G.;Roobol, M. J.;de Koning, H. J.
通讯作者：
de Koning, H. J.
影响因子：
5.4
作者：
Korfage, Ida Joanna;Hak, Tony;Essink-Bot, Marie-Louise
通讯作者：
Essink-Bot, Marie-Louise
影响因子：
3.6
作者：
Dale, William;Basu, Anirban;Meltzer, David
通讯作者：
Meltzer, David
影响因子：
158.5
作者：
Steineck, G;Helgesen, F;Holmberg, L
通讯作者：
Holmberg, L
影响因子：
6.4
作者：
Korfage, IJ;Essink-Bot, ML;de Koning, HJ
通讯作者：
de Koning, HJ