Prognostic index for predicting prostate cancer survival in a randomized screening trial: Development and validation

Subas Neupane, Jaakko Nevalainen, Jani Raitanen, Kirsi Talala, Paula Kujala, Kimmo Taari, Teuvo L.J. Tammela, Ewout W. Steyerberg, Anssi Auvinen

Research output: Contribution to journalArticleScientificpeer-review


We developed and validated a prognostic index to predict survival from prostate cancer (PCa) based on the Finnish randomized screening trial (FinRSPC). Men diagnosed with localized PCa (N = 7042) were included. European Association of Urology risk groups were defined. The follow-up was divided into three periods (0–3, 3–9 and 9–20 years) for development and two corresponding validation periods (3–6 and 9–15 years). A multivariable complementary log–log regression model was used to calculate the full prognostic index. Predicted cause-specific survival at 10 years from diagnosis was calculated for the control arm using a simplified risk score at diagnosis. The full prognostic index discriminates well men with PCa with different survival. The area under the curve (AUC) was 0.83 for both the 3–6 year and 9–15 year validation periods. In the simplified risk score, patients with a low risk score at diagnosis had the most favorable survival, while the outcome was poorest for the patients with high risk scores. The prognostic index was able to distinguish well between men with higher and lower survival, and the simplified risk score can be used as a basis for decision making.

Original languageEnglish
Article number435
Number of pages13
Issue number3
Publication statusPublished - 2021
Publication typeA1 Journal article-refereed


  • Mortality
  • Prediction model
  • Prognostic index
  • Prostate cancer
  • Screening trial

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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