Lead time and overdiagnosis in prostate-specific antigen screening: importance of methods and context.

Publication Type:

Journal Article


Journal of the National Cancer Institute, Volume 101, Issue 6, p.374-83 (2009)


2009, Aged, Aged, 80 and over, Center-Authored Paper, Early Detection of Cancer, Europe, Humans, Incidence, Male, Mass Screening, Middle Aged, Models, Statistical, Models, Theoretical, Netherlands, Prostate-Specific Antigen, Prostatic Neoplasms, Public Health Sciences Division, Risk Assessment, Risk Factors, SEER Program, Sensitivity and Specificity, Shared Resources, Time Factors, Tumor Markers, Biological, United States


The time by which prostate-specific antigen (PSA) screening advances prostate cancer diagnosis, called the lead time, has been reported by several studies, but results have varied widely, with mean lead times ranging from 3 to 12 years. A quantity that is closely linked with the lead time is the overdiagnosis frequency, which is the fraction of screen-detected cancers that would not have been diagnosed in the absence of screening. Reported overdiagnosis estimates have also been variable, ranging from 25% to greater than 80% of screen-detected cancers.