Evaluating the performance of serum prostate-specific antigen (PSA) test in population-based screening with receiver operating characteristics (ROC) curve often neglects the time dimension. Asymptomatic cases with negative PSA test would have been missed if sojourn time is not taken into account to allow for cases surfacing into the clinical phase. Data included 20,796 men with PSA test at the first screening round was used from population-based Finnish prostate cancer screening trial during 1996–1999. Cancers detected at the first screen, together with interval cancers ascertained during 4-year follow-up were expediently used to estimate sensitivity and specificity. A sojourn-time-corrected model was applied to estimating the possible false negative cases for those with PSA < 4 ng/ml for correcting the ROC curve. The estimated sensitivity estimate was reduced from 94.4% without correction to 68.8% with correction but the estimated specificity was identical (89.4% vs. 89.2%) at cutoff of 3 ng/ml. The corrected area under curve (AUC) [77.0% (74.9–79.1%)] of the PSA test was significantly lower than the uncorrected AUC [95.9% (95.3–96.6%)]. The failure of considering the time since last negative screen due to incomplete ascertainment for asymptomatic cancer led to the overestimation of PSA test performance that further affects the cut-off value of PSA tests for population-based prostate cancer screening.

在基于人群的筛查中使用接收者操作特征（ROC）曲线评估血清前列腺特异性抗原（PSA）测试的性能通常会忽略时间范围。如果不考虑停留时间以使病例进入临床阶段，则将错过PSA试验阴性的无症状病例。数据包括1996-1999年间基于人群的芬兰前列腺癌筛查试验中使用的20796例男性在第一轮筛查中进行了PSA测试。方便地使用在第一次筛查中发现的癌症以及在4年随访中确定的间隔性癌症来估计敏感性和特异性。应用定居时间校正模型估算PSA <4 ng / ml的假阴性病例，以校正ROC曲线。估计的灵敏度估计值从未经校正的94.4％降低为经过校正的68.8％，但截断值为3 ng / ml时，估计的特异性相同（89.4％对89.2％）。PSA测试的曲线下校正面积（AUC）[77.0％（74.9–79.1％）]显着低于未校正的AUC [95.9％（95.3–96.6％）]。由于对无症状癌症的不完全确定而未能考虑自上次阴性筛查以来的时间，导致对PSA检测性能的高估，这进一步影响了PSA检测在基于人群的前列腺癌筛查中的临界值。PSA测试的1％]明显低于未校正的AUC [95.9％（95.3–96.6％）]。由于对无症状癌症的不完全确定而未能考虑自上次阴性筛查以来的时间，导致对PSA检测性能的高估，这进一步影响了PSA检测在基于人群的前列腺癌筛查中的临界值。PSA测试的1％]明显低于未校正的AUC [95.9％（95.3–96.6％）]。由于对无症状癌症的不完全确定而未能考虑自上次阴性筛查以来的时间，导致对PSA检测性能的高估，这进一步影响了PSA检测在基于人群的前列腺癌筛查中的临界值。