title: Test sensitivity in the European prostate cancer screening trial: results from Finland, Sweden, and the Netherlands.
abstract: Test sensitivity pertains to the ability of a test to identify subjects with the target disorder. In cancer screening, test sensitivity can be estimated using interval cancer incidence as an indicator of false-negative result. A randomized trial provides the optimal approach for estimating test sensitivity, as the control arm provides the expected rates. We estimated the sensitivity of the prostate-specific antigen test using incidence method, i.e., based on incidence of interval cancer among subjects with negative screening results, compared with that in the control arm. Data from three centers in the European randomized screening trial were used to estimate interval cancer incidence (I(I)) among 39,389 men with negative screening tests. This was compared with incidence among the 79,525 men in the control arm of the trial (I(c)) to estimate test sensitivity (S = 1 - I(I) / I(C)). Confidence intervals were calculated using simulations, assuming that the number of cases follows a Poisson distribution. The estimated test sensitivity following the first screen was 0.87 (0.83-0.92) in Finland, 0.87 (0.62-1.00) in Sweden, and 0.93 (95% confidence interval, 0.90-0.96) in the Netherlands. There was some indication of a higher test sensitivity for aggressive cancers (0.85-0.98 for non-organ-confined cases or Gleason 8-10) and for the second screening round (approximately 0.85-0.95). Test sensitivity varied to some extent between the three centers in the European trial, probably reflecting variation in screening protocols, but was acceptable in the first screening round, and may be better for aggressive cancers and in the second screening round.
authors: Tampere School of Public Health, University of Tampere, Tampere, Finland. anssi.auvinen@uta.fi
authors: Anssi
authors: A
authors: Auvinen
authors: Jani
authors: J
authors: Raitanen
authors: Sue
authors: S
authors: Moss
authors: Harry J
authors: HJ
authors: de Koning
authors: Jonas
authors: J
authors: Hugosson
authors: Teuvo
authors: T
authors: Tammela
authors: Monique
authors: M
authors: Roobol
authors: Hans
authors: H
authors: Lilja
authors: Matti
authors: M
authors: Hakama
mesh_terms: D000368:Aged; D016001:Confidence Intervals; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
chemical_list: D017430:Prostate-Specific Antigen