• Stijn Roemeling, Monique J Roobol, Michael W Kattan, Theo H van der Kwast, Ewout W Steyerberg, and Fritz H Schröder.
• Department of Urology, Erasmus MC, University Medical Center, Rotterdam, Netherlands. s.roemeling@erasmusmc.nl
• Cancer. 2007 Nov 15; 110 (10): 2218-21.

BackgroundScreening for prostate cancer has resulted in an increased incidence-to-mortality ratio. Not all cancers deserve immediate treatment. It has therefore become more important to be able to identify those cases of screen-detected prostate cancer most likely to show indolent behavior.MethodsThe Kattan-nomogram for the prediction of indolent prostate cancer was validated and recalibrated for use in a screening setting. The recalibrated nomogram was used to calculate the number of men who were predicted to have indolent cancer in a screen-detected cohort from the European Randomized study of Screening for Prostate Cancer (ERSPC), section Rotterdam.ResultsOf 1629 cancers detected in 2 subsequent screening rounds 825 were suitable for nomogram use. The remainder were very unlikely to have indolent cancer. A total of 485 men (485 of 825 = 59%) were predicted to have indolent cancer, which is 30% (485 of 1629) of all screen-detected cases. Cancers found at repeated screening after 4 years had a higher probability of indolent cancer than cases from the prevalence screening (44% vs 23%; P < .001).ConclusionsThe current nomogram can identify substantial groups of screen-detected cancers that are likely indolent and can therefore be considered for active surveillance.(c) 2007 American Cancer Society.

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