Harms and benefits of prostate cancer screening and active surveillance

Prostate cancer is the second most commonly diagnosed cancer and the 5th cause of cancer death worldwide. The PSA-test consists of a simple blood test which gives the value of PSA in the blood. An elevated PSA value indicates a high probability of presence of cancer, though it could also be due to unrelated causes. While prostate cancer screening may save lives, it also causes harm, since many screen-detected men are overdiagnosed and overtreated.
In this thesis I use a microsimulation model (MISCAN) adapted to prostate cancer to explore multiple avenues to make PSA-based screening worthwhile and effective. I find that prostate cancer screening should be focused on younger age groups, Active Surveillance should become the primary treatment option for low-risk men, and that personalized screening strategies should be adopted to minimize the harms of screening.