BACKGROUND. Screening 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. METHODS. The 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. RESULTS. Of 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). CONCLUSIONS. The current nomogram can identify substantial groups of screen-detected cancers that are likely indolent and can therefore be considered for active surveillance.

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Keywords Prostate cancer, Risk assessment, Screening
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Roemeling, S., Roobol, M.J., Kattan, M.W., van der Kwast, Th.H., Steyerberg, E.W., & Schröder, F.H.. (2007). Nomogram use for the prediction of indolent prostate cancer: Impact on screen-detected populations. Cancer, 110(10), 2218–2221. doi:10.1002/cncr.23029