Asymptornatic incidence and duration of prostate cancer

Ruth Etzioni, Raymond Cha, Eric J. Feuer, Ori Davidov

Research output: Contribution to journalArticlepeer-review


Prostate cancer is known as a disease with an extremely high prevalence relative to its clinical incidence in the population. The combination of preclinical incidence and duration that could yield this phenomenon is of tremendous interest to researchers trying to understand the natural history of the disease and to develop efficient screening strategies. In this article, the authors present estimates of the age-specific asymptomatic incidence and average preclinicat duration of prostate cancer. The methodological approach is to first estimate the age-specific incidence of new (stage Al) prostate cancers using preclinical prevalence data from autopsy studies performed between 1941 and 1964 and clinical incidence data for the years 1960-1986 from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute. Then, the preclinical prevalence estimates are divided by the derived preclinical incidence estimates to yield estimates of the average duration of asymptomatic disease. The estimated mean duration among white men is between 11 and 12 years and appears to be approximately 1 year shorter for blacks than for whites. Comparison of the lifetime risks of preclinical and clinical disease suggests that approximately 75% of prostate cancers will never become diagnosed if clinical incidence remains at levels observed in 1984-1986, prior to the introduction of prostate-specific antigen (PSA) screening in the population.

Original languageEnglish
Pages (from-to)775-785
Number of pages11
JournalAmerican Journal of Epidemiology
Issue number8
StatePublished - 15 Oct 1998
Externally publishedYes


  • Disease progression
  • Natural history
  • Prevalence
  • Prostatic neoplasms
  • SEER program

ASJC Scopus subject areas

  • General Medicine


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