biostudies-literatureUnknown9(3)Pathirana TNational Health and Medical Research Council<h4>Objectives</h4>To quantify the risk of overdiagnosis associated with prostate cancer screening in Australia using a novel lifetime risk approach.<h4>Design</h4>Modelling and validation of the lifetime risk method using publicly available population data.<h4>Setting</h4>Opportunistic screening for prostate cancer in the Australian population.<h4>Participants</h4>Australian male population (1982-2012).<h4>Interventions</h4>Prostate-specific antigen testing for prostate cancer screening.<h4>Primary and secondary outcome measures</h4>Primary: lifetime risk of overdiagnosis in 2012 (excess lifetime cancer risk adjusted for changing competing mortality); Secondary: lifetime risk of prostate cancer diagnosis (unadjusted and adjusted for competing mortality); Excess lifetime risk of prostate cancer diagnosis (for all years subsequent to 1982).<h4>Results</h4>The lifetime risk of being diagnosed with prostate cancer increased from 6.1% in 1982 (1 in 17) to 19.6% in 2012 (1 in 5). Using 2012 competing mortality rates, the lifetime risk in 1982 was 11.5% (95% CI 11.0% to 12.0%). The excess lifetime risk of prostate cancer in 2012 (adjusted for changing competing mortality) was 8.2% (95% CI 7.6% to 8.7%) (1 in 13). This corresponds to 41% of prostate cancers being overdiagnosed.<h4>Conclusions</h4>Our estimated rate of overdiagnosis is in agreement with estimates using other methods. This method may be used without the need to adjust for lead times. If annual (cross-sectional) data are used, then it may give valid estimates of overdiagnosis once screening has been established long enough for the benefits from the early detection of non-overdiagnosed cancer at a younger age to be realised in older age groups.BMJ opene022457https://www.ebi.ac.uk/biostudies/studies/S-EPMC6429722biostudies-literatureLifetime risk of prostate cancer overdiagnosis in Australia: quantifying the risk of overdiagnosis associated with prostate cancer screening in Australia using a novel lifetime risk approach.PMC6429722Pathirana THayen AGlasziou PDoust JBell KfalseLifetime risk of prostate cancer overdiagnosis in Australia: quantifying the risk of overdiagnosis associated with prostate cancer screening in Australia using a novel lifetime risk approach.<h4>Objectives</h4>To quantify the risk of overdiagnosis associated with prostate cancer screening in Australia using a novel lifetime risk approach.<h4>Design</h4>Modelling and validation of the lifetime risk method using publicly available population data.<h4>Setting</h4>Opportunistic screening for prostate cancer in the Australian population.<h4>Participants</h4>Australian male population (1982-2012).<h4>Interventions</h4>Prostate-specific antigen testing for prostate cancer screening.<h4>Primary and secondary outcome measures</h4>Primary: lifetime risk of overdiagnosis in 2012 (excess lifetime cancer risk adjusted for changing competing mortality); Secondary: lifetime risk of prostate cancer diagnosis (unadjusted and adjusted for competing mortality); Excess lifetime risk of prostate cancer diagnosis (for all years subsequent to 1982).<h4>Results</h4>The lifetime risk of being diagnosed with prostate cancer increased from 6.1% in 1982 (1 in 17) to 19.6% in 2012 (1 in 5). Using 2012 competing mortality rates, the lifetime risk in 1982 was 11.5% (95% CI 11.0% to 12.0%). The excess lifetime risk of prostate cancer in 2012 (adjusted for changing competing mortality) was 8.2% (95% CI 7.6% to 8.7%) (1 in 13). This corresponds to 41% of prostate cancers being overdiagnosed.<h4>Conclusions</h4>Our estimated rate of overdiagnosis is in agreement with estimates using other methods. This method may be used without the need to adjust for lead times. If annual (cross-sectional) data are used, then it may give valid estimates of overdiagnosis once screening has been established long enough for the benefits from the early detection of non-overdiagnosed cancer at a younger age to be realised in older age groups.2019-01-01T00:00:00Z2019 Mar2024-11-12T01:18:51.272Z2019-08-04T07:37:58ZS-EPMC64297223085815610.1136/bmjopen-2018-022457