International Journal of Cancer最新文献

{"title":"Prognostic Value of Perioperative Anemia in Neurosurgical-Oncological Treatment of Spinal Metastases.","authors":"Marija Janjic, Logman Khalafov, Juliane Dittmer, Saif-Eldin Abedellatif, Tim Lampmann, Harun Asoglu, Mohammed Jaber, Haitham Alenezi, Muriel Heimann, Matthias Schneider, Motaz Hamed, Marcus Thudium, Hartmut Vatter, Mohammed Banat","doi":"10.1002/ijc.70513","DOIUrl":"https://doi.org/10.1002/ijc.70513","url":null,"abstract":"<p><p>Neurosurgical resection of spinal metastases is an established treatment option for selected patients with advanced malignancies. However, high perioperative morbidity and mortality may further compromise outcomes in this vulnerable population, emphasizing the need to identify modifiable prognostic factors. Perioperative anemia is common and clinically relevant, yet its impact in this setting remains insufficiently studied. This retrospective, single-center study included 279 patients who underwent surgical treatment for spinal metastases between 2013 and 2025. Patients were stratified into three groups based on perioperative hemoglobin levels. Multivariable logistic regression, Cox proportional hazards models, and Kaplan-Meier analyses were used to assess associations between perioperative hemoglobin levels and postoperative complications, local recurrence, recurrence-free survival, and mortality at 1 month and 1 year after surgery. Preoperative anemia was independently associated with an increased risk of hospital-acquired complications (odds ratio [OR] 2.31, 95% confidence interval [CI] 1.35-3.97, p = 0.002), while higher hemoglobin levels showed a protective effect. No significant association was found between perioperative hemoglobin levels and surgical complications (OR 0.73, 95% CI 0.36-1.51, p = 0.400). Postoperative hemoglobin levels and perioperative hemoglobin changes were not significantly associated with complications (OR 1.008, 95% CI 0.990-1.026, p = 0.389) or mortality. One-month and one-year mortality rates were lowest in patients without anemia and highest in those with severe anemia. Our data demonstrate that early identification and optimization of preoperative anemia may reduce postoperative complications and potentially improve survival outcomes in patients undergoing surgery for spinal metastases.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Care Policy Implementation Trial of Primary Human Papillomavirus-Based Cervical Screening in Denmark.","authors":"Jesper Bonde, Jeppe Bennekou Schroll, Birgitte Tønnes Pedersen, Elsebeth Lynge, Marianne Waldstrøm, Petra Hall Viborg, Anna Frandsen, Rikke Holst Andersen, Susanne Nielsen, Doris Schledermann, Bettina Kjær Kristensen, Berit Andersen","doi":"10.1002/ijc.70502","DOIUrl":"https://doi.org/10.1002/ijc.70502","url":null,"abstract":"<p><p>On mandate from the Danish Health Authority, a nationwide health care policy trial (HCP) of primary HPV screening for women aged 30-59 was initiated in 2021. The aim was to inform on the performance of HPV screening in comparison to existing cytology practice. The HCP trial included all Danish women between 30 and 59 years of age undergoing cervical cancer screening in 2021 (n = 178,323). Women with odd birthdays were screened with HPV screening (n = 91,517), while women born on even dates were screened with cytology (n = 86,806). The follow-up period was individually censored at 18 months from the screening date. Outcomes and intention-to-treat analysis are reported. Overall, 9.1% and 3.0% were HPV or cytology positive on the index sample. Referral to colposcopy upon index sample was 1.9% with HPV and 2.1% with cytology screening. Referral to retest after a positive HPV index sample result was 7.7 higher for HPV than cytology. Combining index and retest rounds, 6.3% women had colposcopy in the HPV arm (RR 1.28) versus 4,9% in the cytology arm. HPV screening detected both more disease ≥ CIN2 (RR 1.51) and ≥ CIN3 (RR1.35). The national-scale health care policy implementation trial showed that HPV-based cervical cancer screening increased detection of histologically defined disease compared to the previous policy of cytology-based screening for women 30-59 years of age. The HCP demonstrated the real-life effect of HPV-based screening over cytology-based screening in detection of disease, but also details what to be expected in terms of health care resource requirements.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood-Based Circulating Tumor DNA Assays for Early Colorectal Cancer Detection: A Systematic Review of Performance in Asymptomatic Screening Populations.","authors":"Caroline Ledertoug Kahn, Maria Wissing Rasmussen, Jakob Kleif, Inge Søkilde Pedersen, Christina Therkildsen","doi":"10.1002/ijc.70498","DOIUrl":"https://doi.org/10.1002/ijc.70498","url":null,"abstract":"<p><p>Early detection of colorectal cancer (CRC) via population-based screening programs can reduce incidence and mortality. Current screening approaches are limited by cost, accessibility, compliance, and colonoscopy capacity. Blood-based screening of circulating tumor (ct) DNA may resolve some of these limitations. This systematic review evaluated the screening potential of blood-based ctDNA assays in asymptomatic screening populations. We systematically searched the PubMed database (final search June 20th, 2025) for studies detecting advanced adenomas (AAs) or CRC in asymptomatic cohorts, where a blood-based ctDNA assay had been evaluated with data on specificity, sensitivity, and/or AUC at early stages of disease. Newcastle-Ottowa scale was used for quality assessment. Only 20 studies of 454 unique hits met our inclusion criteria. Of these, 12 studies used assays targeting specific DNA alterations, while the remaining 8 studies used complex assays. Generally, comprehensive assays such as Shield, ColonSecure, and FMBT-CRC had the best performance for early-stage CRC detection with sensitivities of 71%-85% and specificities of 88%-90%. Despite being tested in a small cohort, the Coloscape assay was the only assay to reach sufficient AA detection with 59% sensitivity and 92% specificity. None of the reviewed ctDNA assays demonstrated sufficient sensitivities for both AA and early-stage CRC detection to be considered future screening tools. Screening tools based on ctDNA assays have not proved superior to fecal-based immunochemical test (FIT) yet. Future studies need to test ctDNA screening tools in large, prospective, asymptomatic cohorts emphasizing AA, and early-stage CRC.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphocyte Micronucleus Formation Is Driven by Inflammation-Induced Oxidative DNA Damage in Oesophageal Cancer Development.","authors":"Kathryn Munn, Rachel Lawrence, Hasan Haboubi, Hamsa Naser, Kate Hurlow, Ume-Kulsoom Shah, Lisa Williams, Sarah Gwynne, Owen Bodger, Jiri Zavadil, Francois Virard, Shareen Doak, Laura E Thomas, Gareth Jenkins","doi":"10.1002/ijc.70494","DOIUrl":"https://doi.org/10.1002/ijc.70494","url":null,"abstract":"<p><p>We investigated mechanisms underlying circulating DNA damage across the gastro-oesophageal reflux disease (GORD), Barrett's oesophagus (BO) and oesophageal adenocarcinoma (OAC) spectrum using the lymphocyte micronucleus (MN) assay. MN frequency (MN%) was quantified in lymphocytes from healthy volunteers (HVs), GORD, BO and OAC patients, alongside plasma biomarkers of inflammation and oxidative stress. Ex vivo challenge assays assessed lymphocyte responses to hydrogen peroxide (H₂O₂), vinblastine and the bile acid deoxycholic acid (DCA). Tissue-based NF-κB expression was also correlated with MN levels. OAC patients exhibited significantly elevated MN% compared with HVs (p < 0.001), GORD (p < 0.001) and BO (p = 0.016). OAC lymphocytes showed increased sensitivity to vinblastine relative to HVs (p = 0.025) and GORD patients (p = 0.033). Higher baseline MN% correlated with reduced inducible MN formation following H₂O₂ or DCA, suggesting altered oxidative stress responses. MN% also associated with plasma 8-OHdG, IL-8 and 2'3'-cGAMP, and with reduced oesophageal tissue IκB, indicating activation of oxidative and cGAS-STING/NF-κB signalling. These findings highlight systemic aneugenic and oxidative stress processes that contribute to lymphocyte MN formation in OAC and suggest that MN% may serve as a minimally invasive indicator of inflammation-linked genomic instability. Further investigation is needed to determine its relevance to OAC progression.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Colonoscopy Surveillance for Lynch Syndrome: Emerging Evidence, Lessons Learned From Average-Risk Populations, and Future Directions.","authors":"Robert Hüneburg, Querijn N E van Bokhorst, Evelien Dekker, Jacob Nattermann","doi":"10.1002/ijc.70496","DOIUrl":"https://doi.org/10.1002/ijc.70496","url":null,"abstract":"<p><p>Lynch syndrome (LS) is the most common hereditary colorectal cancer (CRC) syndrome and is characterized by an accelerated adenoma-carcinoma sequence, a relatively higher prevalence of flat and subtle CRC precursor lesions, and exceptionally high adenoma miss rates despite intensive colonoscopy surveillance. Artificial intelligence (AI), particularly through computer-aided detection (CADe), has demonstrated substantial improvements in adenoma detection in average-risk CRC screening and surveillance populations. Meanwhile, it is unclear whether these benefits also translate to LS, where carcinogenesis, surveillance regimens, and clinical standards differ fundamentally. This narrative review synthesizes the current evidence on AI-assisted colonoscopy in LS, including findings from the randomized controlled CADLY and TIMELY trials. We contextualize these results within the broader body of research on AI-assisted colonoscopy in average-risk CRC screening and surveillance populations. Existing LS-specific data suggest that AI can be safely integrated into high-quality surveillance. Meanwhile, use of AI has not yet been demonstrated to aid in improving overall adenoma or advanced neoplasia detection rates when used by expert colonoscopists, and when adequate baseline procedural quality is guaranteed.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generation of Allogeneic CAR-T Circumvents Functional Deficits in Patient-Derived Autologous Product for Glioblastoma.","authors":"Sabra K Salim, Muhammad Vaseem Shaikh, Jeffrey Wei, William T Maich, Alisha Anand, Oliver Y Tang, Minomi K Subapanditha, Zahra Alizada, Yujin Suk, Manoj Singh, Kui Zhai, Aapti Khanna, Benjamin Brakel, Vassil Dimitrov, Zoya Tabunshchyk, Katie Chan, Kevin R Brown, Parvez Vora, Donald M O'Rourke, Zev A Binder, Chitra Venugopal, Jason Moffat, Sheila K Singh","doi":"10.1002/ijc.70509","DOIUrl":"https://doi.org/10.1002/ijc.70509","url":null,"abstract":"<p><p>Glioblastoma (GBM) is the most common malignant brain tumor in adults, with a poor prognosis despite aggressive standard of care. Chimeric antigen receptor T-cell (CAR-T) therapy has shown promising results in liquid malignancies, but clinical trials in GBM targeting various tumor antigens have not shown durable clinical benefit. While this may be attributable to various tumor-intrinsic immune evasion strategies characteristic of GBM, little work has been done to assess whether the issue is due to the quality of the CAR-T treatment itself. Currently, CAR-Ts for GBMs and liquid malignancies are manufactured in an autologous setting in which T-cells are extracted from patients, engineered ex vivo, and subsequently reinfused back. However, peripheral T-cells taken from untreated GBM patients have demonstrated qualitative and functional deficits, which may contribute to suboptimal treatment outcomes. Thus, we aimed to establish whether CAR-Ts generated from GBM patients would show reduced efficacy in comparison to healthy donors using our previously validated CD133 CAR-T. In this work, we show pre-treatment exhaustion and reduced survival advantage in autologous, patient-derived CD133-targeting CAR-T cell products using an orthotopic xenograft model of human GBM. To overcome the functional and logistical considerations of autologous therapy, we additionally aimed to generate an \"off-the-shelf\" allogeneic CD133 CAR-T. Using CRISPR gene editing technology, we generated TCR-knockout CAR-T cells with comparable pre-clinical efficacy to our autologous models. Ultimately, this work highlights the need to reassess autologous CAR-T therapy for GBM and consider allogeneic approaches as biologically informed therapeutic alternatives.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor Infiltrating Lymphocyte Therapy Combined With PD-1/LAG-3 Inhibition in Patients With Recurrent Platinum-Resistant Ovarian Cancer.","authors":"Tine J Monberg, Cathrine L Lorentzen, Marie C W Westergaard, Trine Z Iversen, Troels H Borch, Marco Donia, Sigrid M Mannering, Stine E W Banke, Özcan Met, Inge Marie Svane","doi":"10.1002/ijc.70510","DOIUrl":"https://doi.org/10.1002/ijc.70510","url":null,"abstract":"<p><p>Patients with ovarian cancer (OC) have not yet benefitted from the advances in immuno-oncology. While tumor infiltrating lymphocytes (TILs) can be expanded from OC tumors, previous trials have not demonstrated lasting responses. High expression of the immune checkpoints PD-1 and LAG-3 on TILs from OC provide a rationale for the addition of immune checkpoint inhibitors (ICI) to the treatment. In this clinical pilot study (NCT04611126), five patients with platinum-resistant recurrent OC were treated with TIL therapy and up to four cycles of combined treatment with PD-1-/LAG-3-inhibitors. The primary endpoint was safety and feasibility, while secondary endpoints included immune monitoring and clinical efficacy. Included patients had undifferentiated carcinoma (n = 1), high-grade serous OC (HGSOC) (n = 2) and low-grade serous OC (LGSOC) (n = 2). The treatment was safe and feasible with expected treatment-related toxicity; however, there was a relatively high rate of non-treatment-related complications. A decrease in tumor burden was observed in 80% (4/5) of patients, including two unconfirmed partial responses. In one patient, the response was supported by in vitro reactivity of the infused TILs toward autologous tumor cell line. Differences in baseline tumor burden, infusion product composition and responses were observed in LGSOC vs. HGSOC. Overall, this exploratory pilot study demonstrated a favorable safety profile and indications of clinical efficacy for TIL therapy combined with PD-1 and LAG-3 inhibition in platinum-resistant OC. Due to the low patient number, the results should be interpreted as hypothesis-generating, providing a rationale for conducting larger trials that carefully consider treatment timing and tumor histology.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Cancer Care Quality Certification With Survival Across Multiple Cancer Types: A Population-Based Cohort Study in Taiwan.","authors":"Hsiao-Chen Chiu, Chun-Ju Chiang, Jing-Rong Jhuang, Dai-Rong Tsai, Li-Ju Lin, Jing-Fong Wang, Wen-Chung Lee","doi":"10.1002/ijc.70516","DOIUrl":"https://doi.org/10.1002/ijc.70516","url":null,"abstract":"<p><p>Cancer remains a major global health burden. Taiwan launched the Cancer Care Quality Certification (CCQC) program in 2008; however, comprehensive evaluations of its association with survival across multiple cancer types remain limited. A total of 294,323 patients diagnosed with one of eight cancer types between 2011 and 2017 were identified from the Taiwan Cancer Registry Database. Overall survival among patients treated at certified versus non-certified hospitals was compared using Cox proportional hazards models incorporating a hospital-level shared frailty to account for institutional heterogeneity, adjusting for age, sex, stage, hospital level, geographic region, and treatment modalities. Treatment at certified hospitals was associated with lower all-cause mortality for colorectal (adjusted hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.83-0.93), lung (HR, 0.91; 95% CI, 0.87-0.96), and bladder cancers (HR, 0.79; 95% CI, 0.66-0.96). No statistically significant associations were observed for liver, female breast, cervical, uterine, or ovarian cancers. In this population-based study, the CCQC program in Taiwan is associated with improved survival for several major cancers, although the magnitude of association varied by cancer type. These findings suggest that certification may serve as a marker of institutional capacity for delivering high-quality cancer care and support the continued evaluation of certification programs as a potential strategy for strengthening cancer care systems.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Benefit and Safety of Combined Immunotherapy and Targeted Therapy in Prostate Cancer.","authors":"Zeyu Han, Xianyanling Yi, Yaxiong Tang, Xuanji Li, Dazhou Liao, Hang Xu, Xiaonan Zheng, Jianzhong Ai","doi":"10.1002/ijc.70512","DOIUrl":"https://doi.org/10.1002/ijc.70512","url":null,"abstract":"<p><p>Although immunotherapy has transformed the treatment of several genitourinary malignancies, its role in prostate cancer remains limited. Combining immunotherapy with targeted therapies has emerged as a promising approach to enhance immune responses in prostate cancer. We aimed to systematically evaluate the efficacy and safety of immunotherapy combined with targeted therapy in the treatment of prostate cancer. We conducted a detailed literature search across Embase, Scopus, PubMed, Web of Science, and the Cochrane Library to include clinical trials enrolling adults with histologically confirmed prostate cancer treated with a combination of targeted therapy and immunotherapy. A systematic review and meta-analysis were performed according to a registered protocol. A total of 21 studies from 19 clinical trials, encompassing 5702 participants, were included. The studies evaluated 12 unique therapeutic combinations involving six targeted agents and four immunotherapies. Seven trials compared combination therapy with monotherapy. Pooled analyses showed that combination therapy significantly improved disease control rate (RR = 1.42), complete response (RR = 2.56), and partial response (RR = 2.13), albeit with a higher incidence of adverse events. In single-arm studies, the pooled median progression-free survival was 5.14 months, and median overall survival was 16.79 months. The androgen receptor signaling inhibitor subgroup exhibited longer survival than the PARP inhibitor subgroup. Combination immunotherapy and targeted therapy demonstrate superior efficacy over monotherapy in prostate cancer but increase the risk of toxicity. These promising results warrant further validation in large-scale, well-designed randomized trials.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Impact of Age on Prostate Cancer Overdiagnosis Using Long-Term Follow-Up From the CAP Randomised Trial.","authors":"Adam R Brentnall, Matejka Rebolj, Peter Sasieni, Garth Funston, Rhian Gabe, Andrew J Vickers","doi":"10.1002/ijc.70492","DOIUrl":"https://doi.org/10.1002/ijc.70492","url":null,"abstract":"<p><p>Prostate cancer overdiagnosis is detection of prostate cancer through PSA testing that otherwise would not have been diagnosed within the patient's lifetime. It is a major concern to policymakers due to its impact on quality of life. We used long-term follow-up data from the CAP randomised trial of a one-off screen, and English male competing mortality rates (2021-23), to estimate the impact of age on excess prostate cancer incidence within 15 years ('overdiagnosis') using competing-risks methods. In total, 2249 (1.19%) of 189,386 men invited for a PSA test in CAP had cancer detected at the one-off screen. Prostate cancer cumulative incidence at 15 years was 7.08% (95% CI 6.95%-7.21%) in those invited to screening, compared with 6.94% (95% CI 6.82%-7.06%) in the control arm; an absolute excess incidence difference of 0.14% (95% CI -0.04% to 0.37%). Excess net incidence to 15 years was 0.14/1.19 = 11.7% (95% CI 0.0%-26.7%) of cases detected at a single prevalent screen. Accounting for competing mortality, men diagnosed at screening aged 50 years were projected to have a 16% chance the cancer would not have been detected within 15 years, rising to 32% if detected at screening aged 70 years and 58% aged 80 years. Thus, prostate cancer overdiagnosis rises substantially with age due to competing mortality, and is relatively low for younger men. Accordingly, policies that enable opportunistic testing should be re-examined in settings where they have led to high rates of screening in older men.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}