Detecting Prostate Ca Overdiagnosis

Use of a “nomogram,” – a calculating device for prediction – can estimate individual risks that a screen-detected prostate cancer has been overdiagnosed, according to a study done at the Fred Hutchinson Cancer Research Center in Seattle and published January 6th 2014 in the Journal of the National Cancer Institute.

A release from the publisher notes that the authors used a standard definition of overdiagnosis to refer to a cancer that would not have become symptomatic or clinically identifiable if it had not been detected by screening. Overdiagnosed cancers do not pose a risk to the patient and do not require treatment, which is associated with significant risks of impotence and incontinence. Previous studies have estimated the risk of overdiagnosis for the US population, with results ranging from 23% to 42% of screen detections. However, risks of overdiagnosis can vary considerably depending on the patient's age and tumor characteristics, highlighting the need for a personalized tool to predict the likelihood of overdiagnosis. The nomogram incorporated age, Gleason score (a tool for assessing stages of prostate cancer), and prostate-specific antigen (PSA) level at diagnosis.

Roman Gulati, M.S and colleagues developed the overdiagnosis nomogram to help patients and clinicians make informed treatment decisions about screen-detected prostate cancers. The authors used a microsimulation model to generate virtual life histories for a representative population of US men between 1975 and 2005. Men who develop cancer can be detected based on elevated PSA levels or development of symptoms. The model used prostate cancer incidence data from the Surveillance, Epidemiology, and End Results registry to estimate risks of prostate cancer progression and detection in the absence and presence of PSA screening. A prediction model was then developed to predict individual chances of overdiagnosis (i.e., the chance that other-cause death would precede diagnosis in the absence of PSA screening) given information known at screen detection. The prediction model estimates that the chances of overdiagnosis range from 2.9% to 88.1% depending on patient age, PSA, and Gleason score.

The authors wrote: "It is hoped that the resulting nomogram, tailored to individual patient characteristics known at diagnosis, will provide useful information for patients and their physicians seeking to weigh the likely harms and benefits of the treatment options available for contemporary screen-detected prostate cancers."

However, in an accompanying editorial, Boris Freidlin, Ph.D. and Edward L. Korn, Ph.D., from the Biometric Research Branch, Division of Cancer Treatment and Diagnosis at the National Cancer Institute in Bethesda, MD, caution that each step of the modeling described in the study by Gulati et al makes "multiple unverifiable assumptions that can produce bias." They write that microsimulation could still be useful to increase generalizability of results from randomized trial results. However, Freidlin and Korn question whether the Gulati et al model of the risk of overdiagnosis is useful in guiding treatment decisions of patients with screen-detected prostate cancer: "…once an individual has been screened and found to have prostate cancer, the relevant question is the outcomes of various treatments (treatment morbidity, prostate cancer symptoms and death), and not the probability of an event [detection of prostate cancer] that could have happened if the individual had not been screened."

you may also like

Recipes We

Khela88

Fancywin

Jita Ace

Betjili

https://betvisa1.org/

jeetbuzz লগইন

jeetwin app

baji999

winbuzz

betvisa login

winbuzz

six6s

babu88

marvelbet

krikya

mostplay

4rabet

leonbet

pin up

mostbet

all rummy app

Fastwin

Jitawin

R777

Bhaggo

PBC88

Winbdt

Crickex

Betjee

Glory Casino

Jita Bet

Melbet

Jwin7

Jita Ace

Krikya

Six6s

Betjili

Mostplay

Jeetbuzz

Jeetwin

Mostbet

Baji999

Marvelbet

Betvisa

Mcw

Nagad88

Babu88

Jaya9

babu88 babu88 jeetwin abbabet nagad88 marvelbet melbet mostbet six6s crickex mcw casino baji999 betvisa krikya mostplay crazy time jeetbuzz 79king1 good88 11bet xoso66 nohu78 xin88 nohu90 v9bet fastwin betvisa
jeetbuzz
babu88
babu888
jeetwin
nagad88
jaya9
khela88
mostplay
baji999
abbabet
1xbet 12bet marvel bet 91 club betvisa login baji999 sky247 gugobet lotus365 yolo247 bsport loto188 bsport site 8day xoso66 v9bet rummy deity yono rummy new88 typhu88 jeetbuzz dafabet lotus365 bet88 v9bet đăng nhập thienhabet 188bet link dafabet login betvisa king567 yolo247 login 1xbet login 24betting 91club crickex kubet new88 hi88 jun88 w88 shbet mksports 33win f8bet 123b fb88 vn88 mu88 five88 bk8 w388 gnbet mcw casino thienhabet sodo casino cmd368 bsport eubet sbobet mibet cmd368 Faridabad Satta Satta King 786 Dafabet betvisa yono rummy rummy apk

alo789

https://metalwave.com.mx/app/

https://meisetio.com/wp-includes/js/jquery/ai/index.php?tunnel=alo-789

https://purneauniversity.ac.in/assets/js/mk/?tunnel=baji999

fastwin

fastwin

winzo

winzo

futemax

Kèo nhà cái

bongdadzo

Tỷ số bóng đá

KQBD

Kết quả bóng đá

rummy nabob

hi88

8day

97win

n88

red88

king88

j88

i9bet

good88

nohu78

99ok

bet168

satta king

satta matta matka

Canais Play

ALO789

yono rummy
rummy deity
rummy nabob
rummy wealth
daman games
jeetbuzz
yolo247
baji999
rummy gold
188bet
v9bet
789bet
crickex
1xbet
thienhabet
c54
sky88
33win
79king
kubet
shbet
good88
3king
nohu
lucky88
97win
xoso66
xin88
daga88
yolo247
jeetbuzz
betvisa
jeetwin
baji999
nagad88
babu88
mostplay
babu888
jaya9
khela88
jaya9
khela88
jeetbuzz
betvisa
abbabet
babu88
babu888
jeetwin
nagad88
jaya9
joya 9
khela88
mostplay
marvelbet
baji999

Sponsored From Malaysia

말레이시아에서 후원