{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T17:55:47Z","timestamp":1778867747858,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2025,11,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Overdiagnosis of low\u2010risk prostate cancer (PC), often accompanied by overtreatment, remains an important harmful consequence of prostate\u2010specific antigen (PSA)\u2010based screening. Although PSA screening can reduce PC mortality and metastatic PC, the balance of benefits and harms remains controversial. This retrospective cohort study of 80,144 men from the Finnish Randomized Study of Screening for Prostate Cancer, with a median follow\u2010up of 18.0\u2009years, compared determinants of low\u2010risk PC with determinants of high\u2010risk PC. Low\u2010risk PC (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u20091774) was classified according to the European Association of Urology guidelines, excluding cases with subsequent PC death. A secondary analysis excluded cases with post\u2010diagnosis disease progression. Intermediate, high\u2010risk, and advanced cases were classified as high\u2010risk PC (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u20096466). Poisson regression was used to analyze PC incidence. Low\u2010risk PC was more common in the screening than the control arm (1.9 vs. 1.2 cases per 1000 person\u2010years), whereas high\u2010risk PC was more frequent in the control arm (5.7 vs. 5.4 cases per 1000 person\u2010years in the screening arm). The risk of low\u2010risk PC remained stable across screening rounds, while the risk for high\u2010risk PC declined after the first screen. Age was associated with an increased risk of high\u2010risk PC, but no clear trend by age was observed for low\u2010risk PC. Family history and use of 5\u2010alpha reductase inhibitors showed stronger associations with low\u2010risk PC than high\u2010risk PC, though less so for screen\u2010detected cancers. These suggest that risk factors for low\u2010risk PC differ from those for high\u2010risk PC, with determinants of low\u2010risk PC being more closely related to medical service use.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70026","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T09:39:27Z","timestamp":1752745167000},"page":"2033-2040","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk factors for low\u2010risk prostate cancer: A retrospective cohort study within the\n                    <scp>FinRSPC<\/scp>\n                    trial"],"prefix":"10.1002","volume":"157","author":[{"given":"Uzoamaka E.","family":"Okwor","sequence":"first","affiliation":[{"name":"Faculty of Social Sciences Tampere University  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jani","family":"Raitanen","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences Tampere University  Tampere Finland"},{"name":"UKK Institute for Health Promote Research  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9705-9265","authenticated-orcid":false,"given":"Kirsi","family":"Talala","sequence":"additional","affiliation":[{"name":"Cancer Society of Finland  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teuvo L. 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