Journal of Medical Screening > Volume 14, Number 4 > Pp. 174-177

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hakama, M. Articles by Miller, A. B Search for Related Content PubMed PubMed Citation Social Bookmarking                      What's this?

Original Articles

Sensitivity in cancer screening

Matti Hakama, Anssi Auvinen, Nicholas E Day and Anthony B Miller , Tampere School of Public Health, University of Tampere, Tampere FI-33014, Finland; Finnish Cancer Registry, Helsinki FI-00170, Finland; Finnish Cancer Institute and Tampere School of Public Health, University of Tampere, Tampere FI-33014, Finland; Strangeways Research Laboratory, Institute of Public Health, Cambridge CB1 8RN, UK; Department of Public Health Sciences, University of Toronto, Toronto, ON LOS 1JO, Canada

Objective: We propose three concepts of sensitivity in cancer screening and apply to data on prostate cancer.

Conceptual entities: Sensitivity is the indicator on the ability of screening to find cancer in the detectable preclinical phase (DPCP). The ability is usually specified as to the screening test. We call this entity the test sensitivity. Test positivity with histological confirmation refers to the full diagnostic process and we call the corresponding entity as episode sensitivity. Ultimately, a screening programme identifies a proportion of cancers in the DPCP in the total target population, that we call programme sensitivity. We derive the formulae for these three sensitivities consistent with the incidence method.

Example: Our example on estimation of the three sensitivities is from a randomized screening trial for prostate cancer in Finland. The estimates by incidence method were substantially different, 85% for test sensitivity, 48% for episode sensitivity and 36% for programme sensitivity.

Conclusion: More than one concept of sensitivity with standard method of estimation is needed to describe the ability of screening to identify the disease in the DPCP.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?