Table 4. Selected screening policies by PCM increase threshold, due to less intensive screening, relative to basecase (50-74, 1y, PSAt=3) and ordered by overdiagnosis reduction.
| Maximum PCM Increase Threshold | Screening Policy | Probability Overdx (- Overdx %) | Probability PCM (+ PCM %) |
|---|---|---|---|
| 0% | 50-74, 1y, PSAt = 3 | 3.80 (0.0) | 2.38 (0.0) |
|
| |||
| 1% | 50-74, 1y, PSAt = 3, if age > 65, PSAt < 1 then freq. = 4y | 3.58 (5.9) | 2.39 (0.7) |
| 58-74, 1y, PSAt = 3 | 3.81 (-0.1) | 2.38 (0.8) | |
| 54-74, 1y, PSAt = 3 | 3.81 (-0.2) | 2.40 (0.2) | |
|
| |||
| 2% | 50-72, 1y, PSAt = 3 | 3.12 (18.0) | 2.41 (1.6) |
| 50-74, 1y, PSAt = 3, if age > 65, PSAt < 1 then stop | 3.15 (17.1) | 2.42 (1.9) | |
| 50-74, 2y, PSAt = 3 | 3.51 (7.6) | 2.41 (1.6) | |
|
| |||
| 3% | 50-72, 2y, PSAt = 3 | 2.88 (24.3) | 2.45 (3.0) |
| 50-74, 1y, PSAt = 3, if 66 ≤ age < 70 then PSAt = 4, if age ≥ 70 then PSAt = 5 | 3.10 (18.6) | 2.43 (2.2) | |
| 50-74, 1y, PSAt = 4 | 3.31 (12.8) | 2.44 (2.6) | |
| 62-74, 1y, PSAt = 3 | 3.76 (1.1) | 2.43 (2.2) | |
|
| |||
| 4% | 50-70, 1y, PSAt = 3 | 2.51 (34.0) | 2.46 (3.2) |
| 50-74, 1y, PSAt = 3, if age > 60, PSAt < 1 then stop | 2.75 (27.6) | 2.47 (3.6) | |
| 50-74, 4y, PSAt = 3 | 3.07 (19.4) | 2.47 (3.8) | |
|
| |||
| 5% | 50-70, 1y, PSAt = 3, if age > 66 then PSAt = 4 | 2.15 (43.4) | 2.49 (4.5) |
| 55-69, 1y, PSAt = 3 | 2.24 (41.0) | 2.48 (4.4) | |
| 50-70, 2y, PSAt = 3 | 2.31 (39.2) | 2.49 (4.5) | |
| 50-74, 1y, PSAt = 4, 66 ≤ age < 70 then PSAt = 5, if age ≥ 70 then PSAt = 7 | 2.61 (31.2) | 2.49 (4.6) | |
|
| |||
| 6% | 50-68, 1y, PSAt = 3 | 1.97 (48.3) | 2.50 (5.1) |
| 55-69, 2y, PSAt = 3 | 2.08 (45.3) | 2.51 (5.4) | |
| 50-70, 1y, PSAt = 4 | 2.13 (43.9) | 2.51 (5.5) | |
|
| |||
| 7% | 50-66, 1y, PSAt = 3 | 1.48 (61.1) | 2.55 (6.9) |
| 50-70, 1y, PSAt = 4, 66 ≤ age < 70 then PSAt = 5, if age ≥ 70 then PSAt = 7 | 1.84 (51.6) | 2.54 (6.4) | |
| 55-69, 1y, PSAt = 4 | 1.88 (50.4) | 2.54 (6.3) | |
| 50-70, 4y, PSAt = 3 | 1.99 (47.5) | 2.53 (6.3) | |
|
| |||
| 17% | Stop Screening 2012 | 0.00 (100.0) | 2.83 (16.2) |
|
| |||
| Screening Men Older than 75 | |||
|
| |||
| -1% | 50-76, 1y, PSAt = 3 | 4.56 (-20.0) | 2.34 (-1.4) |
|
| |||
| -3% | 50-80, 1y, PSAt = 3 | 6.26 (-64.6) | 2.30 (-3.6) |
#
All other screening policies are shown in Online Supplement tables 3 (by screening frequency and start stop age) and 4 (PSA based risk stratification, PSAt dependent on age, screening men older than 75).
##
Reduction (-) or increase (+), in percentage, relative to base case (50-74, PSAt=3, yearly screening). Screening policies are ordered by overdiagnosis reduction.
*
PSAt stands for prostate-specific antigen threshold for biopsy referral, Overdx for Overdiagnosis, PCM for prostate cancer mortality.