Over-diagnosis and under-diagnosis of screen- vs non-screen-detected prostate cancers with in men with prostate-specific antigen levels of 2.0-10.0 ng/mL.
OBJECTIVE
To evaluate possible over- and under-diagnosis of prostate cancer in a screened vs a referral population in the same range of prostate-specific antigen (PSA).


METHODS
In all, 1445 patients undergoing radical prostatectomy and with a PSA level of <10 ng/mL were evaluated; 237 were from outside Tyrol (Austria) and represented the unscreened group, and 1208 were Tyrolean screening volunteers. Over-diagnosis was defined as a pathological stage of pT2a and a Gleason score of <7 with no positive surgical margins. Under-diagnosis was defined as a pathological stage of >or=pT3a or positive surgical margins. The chi-square test was used to assess the differences, with P < 0.05 considered to indicate statistical significance.


RESULTS
There were no significant differences in patient age or PSA levels between the study groups. There was over-diagnosis in the screening and referral groups in 17.4% and 8.9%, respectively, and under-diagnosis in 18.6% and 42.2%, respectively.


CONCLUSIONS
This study suggests that patients with prostate cancer participating in a screening programme are less likely to be under-diagnosed or have extracapsular disease than their counterparts in a referral population, even in the same PSA range, after radical prostatectomy. Furthermore, there was more under-diagnosis in the referral group than over-diagnosis in the screened group.
Pelzer
Alexandre E
AE
Department of Urology, Medical University Innsbruck, Austria. alexandre.pelzer@uki.at
Colleselli
Daniela
D
Bektic
Jasmin
J
Schaefer
Georg
G
Ongarello
Stefano
S
Schwentner
Christian
C
Aigner
Fritz
F
Mitterberger
Michael
M
Steiner
Eberhard
E
Bartsch
Georg
G
Horninger
Wolfgang
W
D000328:Adult; D000368:Aged; D001317:Austria / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D012017:Referral and Consultation
D017430:Prostate-Specific Antigen