+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Screening and prostate-cancer mortality in a randomized European study



Screening and prostate-cancer mortality in a randomized European study



New England Journal of Medicine 360(13): 1320-1328



The European Randomized Study of Screening for Prostate Cancer was initiated in the early 1990s to evaluate the effect of screening with prostate-specific-antigen (PSA) testing on death rates from prostate cancer. We identified 182,000 men between the ages of 50 and 74 years through registries in seven European countries for inclusion in our study. The men were randomly assigned to a group that was offered PSA screening at an average of once every 4 years or to a control group that did not receive such screening. The predefined core age group for this study included 162,243 men between the ages of 55 and 69 years. The primary outcome was the rate of death from prostate cancer. Mortality follow-up was identical for the two study groups and ended on December 31, 2006. In the screening group, 82% of men accepted at least one offer of screening. During a median follow-up of 9 years, the cumulative incidence of prostate cancer was 8.2% in the screening group and 4.8% in the control group. The rate ratio for death from prostate cancer in the screening group, as compared with the control group, was 0.80 (95% confidence interval [CI], 0.65 to 0.98; adjusted P=0.04). The absolute risk difference was 0.71 death per 1000 men. This means that 1410 men would need to be screened and 48 additional cases of prostate cancer would need to be treated to prevent one death from prostate cancer. The analysis of men who were actually screened during the first round (excluding subjects with noncompliance) provided a rate ratio for death from prostate cancer of 0.73 (95% CI, 0.56 to 0.90). PSA-based screening reduced the rate of death from prostate cancer by 20% but was associated with a high risk of overdiagnosis. (Current Controlled Trials number, ISRCTN49127736.)

(PDF emailed within 0-6 h: $19.90)

Accession: 055670317

Download citation: RISBibTeXText

PMID: 19297566

DOI: 10.1056/NEJMoa0810084


Related references

Prostate-specific antigen-based prostate cancer screening: reduction of prostate cancer mortality after correction for nonattendance and contamination in the Rotterdam section of the European Randomized Study of Screening for Prostate Cancer. European Urology 65(2): 329-336, 2014

Mortality due to prostate cancer in the Spanish arm of the European Randomized Study of Screening for Prostate Cancer (ERSPC). Results after a 15-year follow-up. Actas Urologicas Espanolas 36(7): 403-409, 2012

Re: No excess mortality after prostate biopsy: results from the European randomized study of screening for prostate cancer. Journal of Urology 188(1): 181-182, 2012

No excess mortality after prostate biopsy: results from the European Randomized Study of Screening for Prostate Cancer. Bju International 107(12): 1912-1917, 2011

Prostate specific antigen testing and digital rectal examination before and during a randomized trial of screening for prostate cancer: European randomized study of screening for prostate cancer, Rotterdam. Journal of Urology 164(4): 1216-1220, October, 2000

Cancer care in the Palestinian territories. Lancet. Oncology 19(7): E359-E364, 2018

Prostate cancer mortality reduction by prostate-specific antigen-based screening adjusted for nonattendance and contamination in the European Randomised Study of Screening for Prostate Cancer (ERSPC). European Urology 56(4): 584-591, 2010

Is prostate-specific antigen velocity selective for clinically significant prostate cancer in screening? European Randomized Study of Screening for Prostate Cancer (Rotterdam). European Urology 55(2): 385-392, 2008

Impact of recent screening on predicting the outcome of prostate cancer biopsy in men with elevated prostate-specific antigen: data from the European Randomized Study of Prostate Cancer Screening in Gothenburg, Sweden. Cancer 116(11): 2612-2620, 2010

Interval cancers in prostate cancer screening: comparing 2- and 4-year screening intervals in the European Randomized Study of Screening for Prostate Cancer, Gothenburg and Rotterdam. Journal of the National Cancer Institute 99(17): 1296-1303, 2007

Words of wisdom. Re: Is prostate-specific antigen velocity selective for clinically significant prostate cancer in screening? European randomized study of screening for prostate cancer (Rotterdam). Wolters T, Roobol MJ, Bangma CH, Schröder PH. European Urology 54(4): 945-946, 2008

Number of Screening Rounds and Postscreening Prostate Cancer Incidence: Results from the Finnish Section of the European Randomized Study of Screening for Prostate Cancer Study. European Urology 70(3): 499-505, 2016

Evaluation of the digital rectal examination as a screening test for prostate cancer. Rotterdam section of the European Randomized Study of Screening for Prostate Cancer. Journal of the National Cancer Institute 90(23): 1817-1823, 1998

Screening for prostate cancer decreases the risk of developing metastatic disease: findings from the European Randomized Study of Screening for Prostate Cancer (ERSPC). European Urology 62(5): 745-752, 2013