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. Author manuscript; available in PMC: 2013 Dec 4.
Published in final edited form as: Ann Intern Med. 2013 Jun 4;158(11):831–838. doi: 10.7326/0003-4819-158-11-201306040-00008

Table 1.

A selection of studies of overdiagnosis due to prostate cancer screening, labeled according to the measure of overdiagnosis, the study design and context, and the estimation approach used. Studies were selected to reflect a range of choices of overdiagnosis measures, contexts and methods and to include recent, high-profile publications

Author Years of study Estimate Measure Approach Context
Etzioni, 2002 (18) 1988– 1999 29% in whites, 44% in blacks Cases overdiagnosed/screen-detected cases Lead-time US SEER9
Age 60–84
Population study
Draisma, 2003 (13) 1994– 2000 48% Cases overdiagnosed/detected cases Lead-time ERSPC Rotterdam
Age 55–67
Screened every 4 years
PSA cutoff: 3.0 μg/L
Clinical trial
Telesca, 2008 (6) 1973– 2000 23% in whites, 34% in blacks Cases overdiagnosed/screen-detected cases Lead-time US SEER9
Age 50–84
Population study
Draisma, 2009 (23) 1985– 2000 23%, 28%, 42%
9%, 12%, 19%
Cases overdiagnosed/screen-detected cases
Cases overdiagnosed/all detected cases
Lead-time US SEER9
Age 50–84
Population study
Wu, 2012 (34) 1996– 2005 3.4 % Cases overdiagnosed/Screenees Lead-time ERSPC Finland
Age 55–67
Screened every 4 years
PSA cutoff 4.0 μg/L
RCT
Welch, 2009 (32) 1986– 2005 1.3 million Excess cases Excess incidence* US SEER9
Age 20+
Population study
Schröder, 2009 (20) 1991– 2006 48 Excess cases/lives saved Excess incidence* ERSPC
Age 55–69
Screened every 2 or 4 years
Clinical trial
Pashayan, 2006 (7) 1996– 2002 40–64% Cases overdiagnosed/cases detected by PSA test Excess incidence* Cambridge, UK
PSA used as diagnostic test, not for routine screening
Population study
Zappa, 1998 (35) 1992– 1995 51% Excess cases/cases in absence of screening Excess incidence* Florence, Italy
Age 60 at entry
6 biennial screens
Population study

PSA = prostate-specific antigen; SEER9 = core 9 catchment areas of the Surveillance, Epidemiology, and End Results program; ERSPC = European Randomized Study of Screening for Prostate Cancer

*

Includes early years of screening use