MISCAN: estimating lead-time and over-detection by simulation.

Abstract

To estimate the mean lead-time and rate of over-detection associated with screening for prostate cancer with prostate-specific antigen. Simulation models, fitted to the results of the Rotterdam section of the European Randomized Study of Screening for Prostate Cancer, were used to predict the mean lead-time and over-detection rate in population-based screening programmes. The mean lead-time is estimated to be 11-12 years and over-detection to occur in half the cases found by population screening. The estimates are compared with published estimates. The effect of lead-time and over-detection on the balance of positive and negative consequences of screening cannot be neglected.