? ? This application proposes the analysis of trends in prostate cancer incidence and mortality using a MISCAN prostate cancer model representative of US conditions. The model should combine evidence obtained in the European randomized study of screening for prostate cancer (ERSPC) with estimates of prostate cancer epidemiology, intervention efforts and treatment of prostate cancer in the US. ? ? The model should correctly predict recent trends in incidence and mortality, and quantify the contributions of prostate-specific antigen (PSA) screening and developments in treatment to these trends. Moreover the model should quantify the tradeoff between morbidity caused by interventions like PSA screening or new treatments, and the realized reductions in mortality. Finally the model will be used to identify optimal screening and treatment strategies. ? ?
