Why Are a High Overdiagnosis Probability and a Long Lead Time for Prostate Cancer Screening So Important?
Affiliations of authors: Medical Practices Evaluation Center, Massachusetts General Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA Correspondence to: Michael J. Barry, MD, Medical Practices Evaluation Center, Massachusetts General Hospital, 50 Staniford St—9th Floor, Boston, MA 02114, USA (e-mail: mbarry{at}partners.org’ + u + ‘@’ + d + ”//–>). In this issue of the Journal, Draisma et al. (1) thoughtfully and carefully estimate the proportion of prostate cancers overdiagnosed in the United States from 1985 through 2000, the early prostate-specific antigen (PSA) era in the United States. They also examine the lead time of PSA screening in that era, using several different definitions of lead time. They use three different independently developed models to estimate these parameters, calibrating each of the models to the observed incidence of prostate cancer in the United States over this time interval. They estimate an overdiagnosis probability, which
