Related Experiment Video
Updated: Apr 23, 2026
07:25
A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
13.4K
Evaluating the Impact of Age on Prostate Cancer Overdiagnosis Using Long-Term Follow-Up From the CAP Randomised Trial
Adam R Brentnall1, Matejka Rebolj1, Peter Sasieni1
1Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
International Journal of Cancer
|April 22, 2026
Summary
Prostate cancer overdiagnosis, the detection of cancers unlikely to affect lifespan, increases with age. This study found overdiagnosis is low in younger men but rises significantly with age due to competing mortality risks.
Area of Science:
- Oncology
- Epidemiology
- Biostatistics
Background:
- Prostate cancer overdiagnosis, defined as detecting cancers that would not impact a patient's life, is a significant policy concern due to its effect on quality of life.
- Prostate-specific antigen (PSA) testing has been linked to increased prostate cancer detection rates, raising questions about overdiagnosis.
Purpose of the Study:
- To estimate the impact of age on prostate cancer overdiagnosis using long-term follow-up data and competing-risks methodology.
- To evaluate the association between age at screening and the likelihood of prostate cancer not being detected within a 15-year timeframe.
Main Methods:
- Utilized long-term follow-up data from the Cancer of the Prostate (CAP) randomized trial, which involved a one-off screening.
- Incorporated English male competing mortality rates (2021-2023) to adjust for mortality risks other than prostate cancer.
- Employed competing-risks statistical methods to analyze excess prostate cancer incidence within 15 years post-screening.
Main Results:
- A total of 2249 (1.19%) men invited for PSA testing in the CAP trial were diagnosed with prostate cancer.
- The cumulative incidence of prostate cancer at 15 years was 7.08% in the screening arm versus 6.94% in the control arm, an absolute excess incidence difference of 0.14%.
- The projected chance of a diagnosed cancer not being detected within 15 years increased with age: 16% at age 50, 32% at age 70, and 58% at age 80.
Conclusions:
- Prostate cancer overdiagnosis increases substantially with age, primarily driven by competing mortality risks.
- Overdiagnosis rates are relatively low for younger men diagnosed via screening.
- Policies promoting opportunistic PSA testing, particularly in older men, warrant re-examination due to the rising rates of overdiagnosis.
Related Concept Videos
02:20Longitudinal Research
11.7K
Sometimes we want to see how people change over time, as in studies of human development and lifespan. When we test the same group of individuals repeatedly over an extended period of time, we are conducting longitudinal research. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time. For example, we may survey a group of individuals about their dietary habits at age 20, retest them a decade later at age 30, and then again...
11.7K
01:21Cancer Survival Analysis
855
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
855
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
348
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
348
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
354
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
354
01:20Actuarial Approach
382
The actuarial approach, a statistical method originally developed for life insurance risk assessment, is widely used to calculate survival rates in clinical and population studies. This method accounts for participants lost to follow-up or those who die from causes unrelated to the study, ensuring a more accurate representation of survival probabilities.
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
382
01:15Drug Dosing: Geriatric Patients
387
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
387