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Researchers Develop Tool To Determine Individual Risk Of Prostate Cancer Overdiagnosis
Date:1/10/2014

ion model representing U.S. men aged 50 to 84 years from 1975 to 2005 and applied existing data on PSA levels, biopsy practices and cancer diagnosis patterns to learn about cancer progression in patients with and without screening. A virtual population was required since it was impossible to know how cancer may have progressed in real patients who were screened and subsequently treated.

The researchers, who also included University of Washington urologist John Gore, M.D., and biostatistician Lurdes Inoue, Ph.D., then overlaid screening and biopsy patterns on the model to determine when the men would have been diagnosed with and without screening, and which would have died of other causes.

They came up with a prediction model which estimates that the likelihood of overdiagnosis ranges from 2.9 to 88.1 percent depending on patient age, PSA level and Gleason score at diagnosis.

The biggest factor in overdiagnosis is age. While treatment may be warranted for a younger man with rapidly growing prostate cancer, its benefits are less clear for, say, a man in his 80s with a less aggressive form of the disease who is more likely to die from other causes before the cancer would become apparent.

While nomograms are common in prostate cancer research, the one developed by the Fred Hutch and UW researchers is the first to determine the likelihood of overdiagnosis on an individual level, said Ruth Etzioni, Ph.D., the paper's senior author.

"We're trying to help patients who are the most likely to be overdiagnosed to recognize it and not be afraid to be more conservative in their treatment," said Etzioni, a biostatistician, cancer modeler and member of the Hutch's Public Health Sciences Division.

Daniel Lin, M.D., a urologist at the University of Washington and an associate member of
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SOURCE Fred Hutchinson Cancer Research Center
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