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dc.contributor.authorJahn, Jaquelyn
dc.contributor.authorGiovannucci, Edward
dc.contributor.authorStampfer, Meir
dc.date.accessioned2019-09-05T17:04:32Z
dc.date.issued2015
dc.identifier.citationJahn, Jaquelyn L., Edward L. Giovannucci, and Meir J. Stampfer. 2015. “The High Prevalence of Undiagnosed Prostate Cancer at Autopsy: Implications for Epidemiology and Treatment of Prostate Cancer in the Prostate-Specific Antigen-Era.” International Journal of Cancer 137 (12): 2795–2802. https://doi.org/10.1002/ijc.29408.
dc.identifier.issn0020-7136
dc.identifier.issn1097-0215
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:41292548*
dc.description.abstractWidespread prostate-specific antigen (PSA) screening detects many cancers that would have otherwise gone undiagnosed. To estimate the prevalence of unsuspected prostate cancer, we reviewed 19 studies of prostate cancer discovered at autopsy among 6,024 men. Among men aged 70-79, tumor was found in 36% of Caucasians and 51% of African-Americans. This enormous prevalence, coupled with the high sensitivity of PSA screening, has led to the marked increase in the apparent incidence of prostate cancer. The impact of PSA screening on clinical practice is well-recognized, but its effect on epidemiologic research is less appreciated. Before screening, a larger proportion of incident prostate cancers had lethal potential and were diagnosed at advanced stage. However, in the PSA era, overall incident prostate cancer mainly is indolent disease, and often reflects the propensity to be screened and biopsied. Studies must therefore focus on cancers with lethal potential, and include long follow-up to accommodate the lead time induced by screening. Moreover, risk factor patterns differ markedly for potentially lethal and indolent disease, suggesting separate etiologies and distinct disease entities. Studies of total incident or indolent prostate cancer are of limited clinical utility, and the main focus of research should be on prostate cancers of lethal potential.
dc.language.isoen_US
dc.publisherWiley
dash.licenseOAP
dc.titleThe High Prevalence of Undiagnosed Prostate Cancer at Autopsy: Implications for Epidemiology and Treatment of Prostate Cancer in the Prostate-Specific Antigen-Era
dc.typeJournal Article
dc.description.versionAccepted Manuscript
dc.relation.journalInternational Journal of Cancer
dash.depositing.authorStampfer, Meir
dc.date.available2019-09-05T17:04:32Z
dash.workflow.comments1Science Serial ID 41212
dc.identifier.doi10.1002/ijc.29408
dash.source.volume137;12
dash.source.page2795
dash.contributor.affiliatedStampfer, Meir


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