Who should be included in a clinical trial of screening for bladder cancer?: A decision analysis of data from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial Journal Article
| Authors: | Vickers, A. J.; Bennette, C.; Kibel, A. S.; Black, A.; Izmirlian, G.; Stephenson, A. J.; Bochner, B. |
| Article Title: | Who should be included in a clinical trial of screening for bladder cancer?: A decision analysis of data from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial |
| Abstract: | Background: Because of its relatively low incidence, bladder cancer screening might have a better ratio of benefits to harms if it is restricted to a high-risk population. Data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial were used and simple decision analytic techniques were applied to compare different eligibility criteria for a screening trial. Methods: For a variety of possible eligibility criteria, the percentage of the population aged 55 years to 74 years and classified as being at high risk for developing invasive or high-grade carcinoma, and therefore likely to benefit from screening, was calculated. Regression models were used to calculate a risk score based on age, sex, smoking history, and family history of bladder cancer. The reduction in cases was calculated given hypothetical risk reductions associated with screening. The trade-off between patients screened and tumors avoided was calculated as a net benefit. Results: The 5-year probability of being diagnosed with invasive bladder cancer was 0.24%. Using a risk score > 6 or > 8 as the eligibility criterion for a trial was generally superior to including all older adults. In a typical scenario, a risk score > 6 would result in approximately 25% of the population being screened to prevent 57 invasive or high-grade bladder cancers per 100,000 population; screening the entire population would prevent only an additional 38 cases. Conclusions: Screening for bladder cancer can be optimized by restricting it to a subgroup of patients considered to be at elevated risk. Different eligibility criteria for a screening trial can be compared rationally using decision-analytic techniques. © 2012 American Cancer Society. |
| Keywords: | research design; bladder cancer; screening; tobacco; clinical trials |
| Journal Title: | Cancer |
| Volume: | 119 |
| Issue: | 1 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2013-01-01 |
| Start Page: | 143 |
| End Page: | 149 |
| Language: | English |
| DOI: | 10.1002/cncr.27692 |
| PROVIDER: | scopus |
| PUBMED: | 22736219 |
| PMCID: | PMC4036636 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 March 2013" - "CODEN: CANCA" - "Source: Scopus" |
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