TY - JOUR
T1 - A stochastic model for survival of early prostate cancer with adjustments for leadtime, length bias, and over-detection
AU - Wu, Grace Hui Min
AU - Auvinen, Anssi
AU - Yen, Amy Ming Fang
AU - Hakama, Matti
AU - Walter, Stephen D.
AU - Chen, Hsiu Hsi
PY - 2012/1
Y1 - 2012/1
N2 - To compare the survival between screen-detected and clinically detected cancers, we applied a series of non-homogeneous stochastic processes to deal with leadtime, length bias, and over-detection by using full information on detection modes obtained from the Finnish randomized controlled trial for prostate cancer screening. The results show after 9-year follow-up the hazard ratio of prostate cancer death for screen-detected cases against clinically detected cases increased from 0.24 (95% CI: 0.16-0.35) without correction for these biases, to 0.76 after correction for leadtime and length biases, and finally to 1.03 (95% CI: 0.79-1.33) for a further adjustment for over-detection. Adjustment for leadtime and length bias but no over-detection led to a 24% reduction in prostate cancer death as a result of prostate-specific antigen test. The further calibration of over-detection indicates no gain in survival of screen-detected prostate cancers (excluding over-detected case as stayer considered in the mover-stayer model) as compared with the control group in the absence of screening that is considered as the mover. However, whether the model assumption on over-detection is robust should be validated with other data sets and longer follow-up.
AB - To compare the survival between screen-detected and clinically detected cancers, we applied a series of non-homogeneous stochastic processes to deal with leadtime, length bias, and over-detection by using full information on detection modes obtained from the Finnish randomized controlled trial for prostate cancer screening. The results show after 9-year follow-up the hazard ratio of prostate cancer death for screen-detected cases against clinically detected cases increased from 0.24 (95% CI: 0.16-0.35) without correction for these biases, to 0.76 after correction for leadtime and length biases, and finally to 1.03 (95% CI: 0.79-1.33) for a further adjustment for over-detection. Adjustment for leadtime and length bias but no over-detection led to a 24% reduction in prostate cancer death as a result of prostate-specific antigen test. The further calibration of over-detection indicates no gain in survival of screen-detected prostate cancers (excluding over-detected case as stayer considered in the mover-stayer model) as compared with the control group in the absence of screening that is considered as the mover. However, whether the model assumption on over-detection is robust should be validated with other data sets and longer follow-up.
KW - Leadtime and length bias
KW - Mass screening
KW - Prostate neoplasms
KW - Prostate-specific antigen
KW - Stochastic processes
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U2 - 10.1002/bimj.201000107
DO - 10.1002/bimj.201000107
M3 - Article
C2 - 22213054
AN - SCOPUS:84862974650
VL - 54
SP - 20
EP - 44
JO - Biometrische Zeitschrift
JF - Biometrische Zeitschrift
SN - 0323-3847
IS - 1
ER -