© 2002 by Oxford University Press
Journal of the National Cancer Institute, Vol. 94, No. 13, 958-960,
July 3, 2002
© 2002 Oxford University Press
EDITORIAL |
Understanding and Appreciating Overdiagnosis in the PSA Era
Affiliation of authors: S.-L. Yao, M.D., Department of Clinical Oncology, Merck Research Laboratories, Rahway, NJ, and Cancer Institute of New Jersey, New Brunswick; G. Lu-Yao, HealthStat, Princeton, NJ.
Correspondence to: Grace Lu-Yao, Ph.D., HealthStat, P.O. Box 7501, Princeton, NJ 08543 (e-mail: gly@aya.yale.edu).
| The first 10% of the full text of this article appears below. |
Screening, for any disease, is often mired in controversy. If there should be any doubts regarding this observation, one only needs to examine the recent uproar surrounding mammography. In that case, seemingly convincing evidence from randomized trials supporting the efficacy of mammography was brought into question decades after the test's widespread acceptance and large-scale implementation (1–4). Take that situation and magnify it by several orders of magnitude and you have the controversy associated with the use of prostate-specific antigen (PSA) screening for the detection of prostate cancer.
Since its introduction in 1987, the use of PSA screening among Medicare beneficiaries has increased substantially (5,6), despite the lack of any truly randomized evidence of its efficacy. Furthermore, the majority
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