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Prostate cancer mortality in screen and clinically detected prostate cancer: Estimating the screening benefit
European Journal of Cancer, 10/07/09

van Leeuwen PJ et al. – A relative reduction in Pca metastasis of 53% and Pca mortality of 37% was observed in the intervention population after 8.5years of observation. The impact of overdiagnosis, quality of life benefits and cost-effectiveness need to be assessed before population-based PSA screening can be recommended

Methods

Total of 11,970 men, aged 55–74years, included in intervention arm of the European Randomised Study of Screening for Prostate Cancer (ERSPC) section Rotterdam
Control population 133,287 men, aged 55–74years, between 1998 and 1999 in Northern Ireland (NI)
Men followed for Pca incidence, metastasis and cause of death until 31st December 2006

Results

Median age 63years at study entry
In Rotterdam 94.2% of men and in NI 6% of men underwent PSA testing
In Rotterdam 1153 men (9.6%) diagnosed with Pca with median baseline PSA of 5.1ng/ml
In NI, 3962 men (3.0%, p<0.001) were diagnosed with Pca with median baseline PSA of 18.0ng/ml
Relative risk of Pca metastasis during observation in the intervention population compared to control population 0.47 (95% confidence interval (CI), 0.35–0.63
Relative risk of Pca-specific mortality also lower in intervention population compared to control population after median follow-up of 8.5years: 0.63 ; absolute mortality reduction was 1.8 deaths per 1000 men

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