MISCAN: estimating lead-time and over-detection by simulation.
OBJECTIVE
To estimate the mean lead-time and rate of over-detection associated with screening for prostate cancer with prostate-specific antigen.


METHODS
Simulation models, fitted to the results of the Rotterdam section of the European Randomized Study of Screening for Prostate Cancer, were used to predict the mean lead-time and over-detection rate in population-based screening programmes.


RESULTS
The mean lead-time is estimated to be 11-12 years and over-detection to occur in half the cases found by population screening. The estimates are compared with published estimates.


CONCLUSIONS
The effect of lead-time and over-detection on the balance of positive and negative consequences of screening cannot be neglected.
Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, the Netherlands. g.draisma@erasmusmc.nl
G
G
Draisma
H J
HJ
De Koning
D000368:Aged; D001706:Biopsy / Q000592:standards; D003198:Computer Simulation; D003627:Data Interpretation, Statistical; D003951:Diagnostic Errors; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000517:prevention & control; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
D017430:Prostate-Specific Antigen