Steven E. Canfield, MD
In men 55 to 69 years of age, does periodic screening with prostate-specific antigen (PSA) testing reduce mortality from prostate cancer?
Randomized controlled trial (European Randomized Study of Screening for Prostate Cancer [ERSPC]). Current Controlled Trials ISRCTN49127736.
Not concealed, at least in part.* In 3 countries, randomization occurred before consent was obtained; in the other 4 countries, only consenting participants were randomized, but allocation concealment was unclear.
Blinded (outcome adjudication committees).*
Median 9 years.
7 European countries.
162 243 men 55 to 69 years of age (mean age 61 y). Some countries also enrolled men outside of this age range, but they were not included in this analysis. Men with a previous diagnosis of prostate cancer were excluded.
Screening, on average, once every 4 years with PSA testing (n = 72 890) or usual care (n = 89 353). In most centers, a serum PSA level > 3.0 ng/mL was considered to be an indication for biopsy or additional diagnostic tests. Men diagnosed with prostate cancer were treated according to local standard practice.
Incidence of and mortality from prostate cancer.
100% (intention-to-screen analysis).
In the screening group, 82% of men were screened at least once. Use of screening in the control group was not reported. In the screening group, more men were diagnosed with prostate cancer and risk for prostate cancer mortality was lower than in the control group (Table). To prevent 1 death from prostate cancer, 1410 men (95% CI 1142 to 1721) would need to be screened and 48 additional men with cancer would need to be treated.
In men 55 to 69 years of age, periodic screening with prostate-specific antigen testing reduced mortality from prostate cancer.
Periodic screening with prostate-specific antigen testing vs usual care in older men†
†Abbreviations defined in Glossary. RRI, RRR, and CI calculated from data in article.
Canfield SE. Periodic screening with prostate-specific antigen testing reduced mortality from prostate cancer. Ann Intern Med. ;150:JC6–5. doi: 10.7326/0003-4819-150-12-200906160-02005
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Published: Ann Intern Med. 2009;150(12):JC6-5.
Hematology/Oncology, Prostate Cancer.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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