Skip to main content
Article
Prevalence of incidental prostate cancer: A systematic review of autopsy studies
International Journal of Cancer (2015)
  • Katy J. L. Bell, Bond University
  • Chris Del Mar, Bond University
  • Gordon Wright, Bond University
  • James Dickinson, University of Calgary
  • Paul Glasziou, Bond University
Abstract

Prostate cancer screening may detect non-progressive cancers, leading to over-diagnosis and over-treatment. The potential for over-diagnosis can be assessed from the reservoir of prostate cancer in autopsy studies that report incidental prostate cancer rates in men who died of other causes. We aimed to estimate the age-specific incidental cancer prevalence from all published autopsy studies.

We identified eligible studies by: searches of Medline and Embase, forward and backward citation searches, and contacting authors. We screened the titles and abstracts of all articles; checked the full text articles for eligibility; and extracted clinical and pathology data using standardized forms. We extracted: mean cancer prevalence, age-specific cancer prevalence, and validity measures, then pooled data from all studies using logistic regression models with random effects.

The 29 studies included in the review dated from 1948 to 2013. Incidental cancer was detected in all populations, with no obvious time trends in prevalence. Prostate cancer prevalence increased with each decade of age, OR =1.7 (1.6 – 1.8) and was higher in studies that used the Gleason score, OR=2.0 (1.1 – 3.7). No other factors were significantly predictive. The estimated mean cancer prevalence increased in a non-linear fashion from 5% (95% CI 3 – 8%) at age59% (95% CI 48 – 71%) by age >79 years. There was substantial variation between populations in estimated cancer prevalence.

There is a substantial reservoir of incidental prostate cancer which increases with age. The high risk of over-diagnosis limits the usefulness of prostate cancer screening. This article is protected by Prostate cancer screening may detect non-progressive cancers, leading to over-diagnosis and

Keywords
  • Prostatic,
  • neoplasms,
  • mass,
  • screening,
  • early detection- of- cancer,
  • autopsy
Publication Date
January 1, 2015
Publisher Statement

Citation only

Bell, K., Del Mar, C., Wright, R., Dickinson, J., Glasziou, J. (2015, in press). Prevalence of incidental prostate cancer: A systematic review of autopsy studies. International journal of cancer.

Access the journal

© Copyright, The Authors, 2015

This work is licensed under a Creative Commons 4.0 Attribution Non-Commercial License

NHMRC Project Grant GNT0527500; APP1013390; 633003

Citation Information
Katy J. L. Bell, Chris Del Mar, Gordon Wright, James Dickinson, et al.. "Prevalence of incidental prostate cancer: A systematic review of autopsy studies" International Journal of Cancer (2015)
Available at: http://works.bepress.com/paul_glasziou/162/