Overdiagnosis in early detection programs.
Overdiagnosis refers to the situation where a screening exam detects a disease that would have otherwise been undetected in a person's lifetime. The disease would have not have been diagnosed because the individual would have died of other causes prior to its clinical onset. Although the probability of overdiagnosis is an important quantity for understanding early detection programs it has not been rigorously studied. We analyze an idealized early detection program and derive the mathematical expression for the probability of overdiagnosis. The results are studied numerically for prostate cancer and applied to a variety of screening schedules. Our investigation indicates that the probability of overdiagnosis is remarkably high.
Davidov
Ori
O
Department of Statistics, University of Haifa, Mount Carmel, Haifa 31905, Israel. davidov@stat.haifa.ac.il
Zelen
Marvin
M
D000368:Aged; D000369:Aged, 80 and over; D042241:Early Diagnosis; D005189:False Positive Reactions; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015233:Models, Statistical; D009716:Numerical Analysis, Computer-Assisted; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*
D017430:Prostate-Specific Antigen