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Table 2 Base-case analyses - model predictions for men with average and elevated familial PCa risk

From: Benefits and harms of prostate cancer screening – predictions of the ONCOTYROL prostate cancer outcome and policy model

 

No screening

One-time screening at age

Interval screening at age 55–59, with interval

Interval screening at age 55–64, with interval

Interval screening at age 55–69, with interval

55y

59y

64y

69y

4y (2 x)

2y (3 x)

1y (5 x)

4y (3 x)

2y (5 x)

1y (10 x)

4y (4 x)

2y (8 x)

1y (15 x)

Predictions for men with average PCa risk

 Lifetime risk of PCa diagnosis (%)

9.00

10.18

11.05

12.76

15.19

11.57

11.96

12.30

13.54

14.18

15.39

16.32

19.27

20.13

 Lifetime risk of PCa diagnosis by screening (%)

-

1.46

2.53

4.55

7.37

3.24

3.76

4.22

5.78

6.67

8.32

9.35

13.33

14.56

 Lifetime risk of overdiagnosis (%)

-

1.18

2.05

3.76

6.19

2.57

2.96

3.30

4.54

5.18

6.39

7.32

10.27

11.13

 Overdiagnosis in screen-detected PCa (%)

-

80.82

81.03

82.64

83.99

79.32

78.72

78.20

78.55

77.66

76.80

78.29

77.04

76.44

 Lifetime prob. of curative local treatment (%)

4.86

5.87

6.59

7.96

9.85

7.13

7.58

8.01

8.92

9.76

11.28

11.42

14.70

16.22

 Lifetime prob. of curative regional treatment (%)

1.62

1.87

2.06

2.44

3.00

2.10

2.07

2.01

2.41

2.27

2.06

2.86

2.74

2.15

 Lifetime prob. of curative loco/regional treatment (%)

6.48

7.74

8.65

10.40

12.85

9.23

9.65

10.02

11.33

12.03

13.34

14.28

17.44

18.37

 Lifetime risk of curative overtreatment (%)

-

1.26

2.17

3.92

6.37

2.75

3.17

3.54

4.85

5.55

6.86

7.80

10.96

11.89

 Curative overtreatment in screen-detected PCa (%)

-

86.30

85.77

86.15

86.43

84.88

84.31

83.89

83.91

83.21

82.45

83.42

82.22

81.66

 Lifetime risk of dying of PCa (%)

1.72

1.69

1.67

1.64

1.63

1.64

1.62

1.60

1.58

1.54

1.47

1.51

1.39

1.30

 Lifetime gained v. no screening (days)

-

0.9

1.1

2.2

1.9

1.9

2.2

2.4

3.3

4.3

7.2

5.8

8.7

12.3

  QALDs gained v. no screening

-

−1.3

−2.3

−3.9

−7.2

−2.8

−3.5

−4.4

−4.9

−5.8

−6.7

−7.3

−10.6

−11.2

 RP-related deaths per 10,000 men (n)

0.70

0.87

0.99

1.20

1.46

1.09

1.15

1.18

1.34

1.46

1.65

1.66

2.23

2.39

 RP- and RT-related AEs per man (n)

0.029

0.034

0.038

0.046

0.057

0.041

0.044

0.046

0.051

0.056

0.063

0.065

0.083

0.090

 PSA screening tests per man (n)

-

0.93

0.89

0.84

0.75

1.81

2.69

4.45

2.63

4.34

8.51

3.37

6.50

12.02

 False-positive PSA tests per man (n)

-

0.13

0.13

0.11

0.09

0.26

0.39

0.66

0.38

0.63

1.25

0.48

0.94

1.76

 PSA tests needed to avoid 1 death (n)

-

2994

1721

1135

848

2369

2774

3893

1964

2460

3382

1660

1964

2854

 Men needed to be screened to avoid one death (n)

-

2994

1721

1135

848

1214

954

809

692

525

368

455

280

220

Predictions for men with elevated familial PCa risk

 Lifetime risk of PCa diagnosis (%)

18.00

19.28

20.23

22.08

24.64

20.79

21.22

21.58

22.93

23.62

24.94

25.92

29.07

30.03

 Lifetime risk of PCa diagnosis by screening (%)

-

1.97

3.36

5.92

9.28

4.37

5.07

5.70

7.79

9.05

11.34

12.53

17.93

19.67

 Lifetime risk of overdiagnosis (%)

-

1.28

2.23

4.08

6.64

2.79

3.22

3.58

4.93

5.62

6.94

7.92

11.07

12.03

 Overdiagnosis in screen-detected PCa (%)

-

64.97

66.37

68.92

71.55

63.84

63.51

62.81

63.29

62.10

61.20

63.21

61.74

61.16

 Lifetime prob. of curative local treatment (%)

8.61

9.73

10.53

11.98

13.88

11.18

11.75

12.31

13.23

14.37

16.39

16.04

20.15

22.37

 Lifetime prob. of curative regional treatment (%)

3.69

4.07

4.35

4.92

5.73

4.40

4.34

4.22

4.88

4.60

4.16

5.55

5.22

4.13

 Lifetime prob. of curative loco/regional treatment (%)

12.29

13.80

14.88

16.90

19.61

15.58

16.09

16.53

18.11

18.97

20.55

21.59

25.37

26.50

 Lifetime risk of curative overtreatment (%)

-

1.51

2.59

4.61

7.32

3.29

3.80

4.24

5.82

6.68

8.26

9.30

13.08

14.21

 Curative overtreatment in screen-detected PCa (%)

-

76.65

77.08

77.87

78.88

75.29

74.95

74.39

74.71

73.81

72.84

74.22

72.95

72.24

 Lifetime risk of dying of PCa (%)

4.35

4.26

4.21

4.15

4.12

4.14

4.09

4.03

3.99

3.87

3.66

3.80

3.46

3.21

 Lifetime gained v. no screening (days)

-

4.7

6.2

7.7

6.6

9.7

12.0

14.4

15.2

20.1

28.6

21.3

32.5

42.7

  QALDs gained v. no screening

-

1.8

1.7

0.3

−3.9

3.6

4.6

5.5

4.7

7.1

10.6

5.1

8.2

13.0

 RP-related deaths per 10,000 men (n)

1.32

1.49

1.64

1.79

2.12

1.73

1.82

1.84

2.01

2.18

2.38

2.39

3.07

3.28

 RP- and RT-related AEs per man (n)

0.052

0.059

0.064

0.073

0.084

0.068

0.071

0.073

0.080

0.085

0.095

0.096

0.118

0.128

 PSA screening tests per man (n)

-

0.92

0.89

0.82

0.73

1.79

2.67

4.40

2.60

4.28

8.34

3.32

6.34

11.66

 False-positive PSA tests per man (n)

-

0.13

0.12

0.11

0.09

0.26

0.39

0.65

0.37

0.62

1.22

0.46

0.90

1.70

 PSA tests needed to avoid 1 death (n)

-

1059

630

415

312

859

1021

1368

714

888

1205

605

712

1023

 Men needed to be screened to avoid one death (n)

-

1059

630

415

312

442

353

287

254

192

133

168

104

81

  1. Results are based on individual level simulation (microsimulation) with 10 million men. Time horizon = 120 years, Compliance = 100%. PCa prostate cancer, QALD quality-adjusted life day, RP radical prostatectomy, RT radiotherapy, AE adverse event
  2. QALDs were primary benefit-harm outcome was indicated in bold
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BMC Public Health

ISSN: 1471-2458

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