Trials of prostate-cancer screening are not worthwhile.
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Trials of prostate-cancer screening are not worthwhile. / Dubben, Hans-Hermann.
In: LANCET ONCOL, Vol. 10, No. 3, 3, 2009, p. 294-298.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Trials of prostate-cancer screening are not worthwhile.
AU - Dubben, Hans-Hermann
PY - 2009
Y1 - 2009
N2 - About 3% of men in developed countries die from prostate cancer. No conclusive evidence, however, either supports or refutes the benefit of prostate-cancer screening. More than 200 000 participants are needed for a screening study with prostate-cancer-specific death as the endpoint. A relative reduction in prostate-cancer mortality of 25% leads to a decrease in absolute risk of less than 1%-a difference of 75 individuals between the control and screening group. Participant non-compliance and small inaccuracies in attributing cause of death need to be compensated for in study size, requiring several million participants. Screening trials with insufficient sample sizes might show a lowering of cancer-specific mortality but not detect increases in all-cause mortality related to screening. Studies of a manageable size have too little discriminatory power and last a long time. Furthermore, results become available decades after trial initiation, by which time they are probably antiquated. Whether screening for prostate cancer is beneficial cannot be assessed in trials, a statement that might also be true for other diseases with low specific mortality.
AB - About 3% of men in developed countries die from prostate cancer. No conclusive evidence, however, either supports or refutes the benefit of prostate-cancer screening. More than 200 000 participants are needed for a screening study with prostate-cancer-specific death as the endpoint. A relative reduction in prostate-cancer mortality of 25% leads to a decrease in absolute risk of less than 1%-a difference of 75 individuals between the control and screening group. Participant non-compliance and small inaccuracies in attributing cause of death need to be compensated for in study size, requiring several million participants. Screening trials with insufficient sample sizes might show a lowering of cancer-specific mortality but not detect increases in all-cause mortality related to screening. Studies of a manageable size have too little discriminatory power and last a long time. Furthermore, results become available decades after trial initiation, by which time they are probably antiquated. Whether screening for prostate cancer is beneficial cannot be assessed in trials, a statement that might also be true for other diseases with low specific mortality.
KW - Humans
KW - Male
KW - Prostatic Neoplasms diagnosis
KW - Cause of Death
KW - Clinical Trials as Topic
KW - Patient Compliance
KW - Sample Size
KW - Humans
KW - Male
KW - Prostatic Neoplasms diagnosis
KW - Cause of Death
KW - Clinical Trials as Topic
KW - Patient Compliance
KW - Sample Size
M3 - SCORING: Zeitschriftenaufsatz
VL - 10
SP - 294
EP - 298
JO - LANCET ONCOL
JF - LANCET ONCOL
SN - 1470-2045
IS - 3
M1 - 3
ER -