Overdiagnosis Since Introduction of Prostate Cancer Screening

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The introduction of prostate-antigen screening, or PSA, has resulted in over 1 million additional men over the last 23 years being diagnosed and treated for prostate cancer—most of whom were likely overdiagnosed, researchers reported in a new study published online August 31 in the Journal of the National Cancer Institute .

Overdiagnosis has been associated with early diagnosis in prostate cancer, but there have been no previous national estimates of its magnitude.

Using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program, H. Gilbert Welch, M.D., MPH, of the White River Junction VA and The Dartmouth Institute for Health Policy & Clinical Practice., and Peter C. Albertsen, M.D., of the University of Connecticut, examined age-specific prostate cancer incidence rates to determine the excess (or deficit) in the number of American men diagnosed and treated in each year after 1986. PSA screening was introduced in 1987.

According to the study, an additional 1.3 million men were diagnosed—that would otherwise have never been diagnosed absent screening—and more than 1 million have been treated since 1986.