Screening and Prostate-Cancer Mortality in a Randomized European Study

• Published in: The New England journal of medicine Vol. 360; no. 13; pp. 1320 - 1328
• Main Authors: Schröder, Fritz H, Hugosson, Jonas, Roobol, Monique J, Tammela, Teuvo L.J, Ciatto, Stefano, Nelen, Vera, Kwiatkowski, Maciej, Lujan, Marcos, Lilja, Hans, Zappa, Marco, Denis, Louis J, Recker, Franz, Berenguer, Antonio, Määttänen, Liisa, Bangma, Chris H, Aus, Gunnar, Villers, Arnauld, Rebillard, Xavier, van der Kwast, Theodorus, Blijenberg, Bert G, Moss, Sue M, de Koning, Harry J, Auvinen, Anssi
• Format: Journal Article Magazine Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 26.03.2009
• Subjects: Age; Age Factors; Aged; Basic Medicine; Biological and medical sciences; Biopsy; blood; Cancer and Oncology; Cancer och onkologi; diagnosis; Digital Rectal Examination; epidemiology; Europe; Europe - epidemiology; Follow-Up Studies; General aspects; Humans; Läkemedelskemi; Male; Mass Screening; Mass Screening - statistics & numerical data; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Medicinal Chemistry; Medicinska och farmaceutiska grundvetenskaper; Men; Middle Aged; Mortality; Nephrology; Njurmedicin; pathology; Patient Compliance; Prevention and actions; Prostate; Prostate - pathology; Prostate cancer; Prostate-Specific Antigen; Prostate-Specific Antigen - blood; Prostatectomy; Prostatic Neoplasms; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - mortality; Prostatic Neoplasms - therapy; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality of Life; Registries; Regression Analysis; Risk; Studies; therapy; Ultrasonography; utilization; Europe; Sweden; Netherlands; Belgium; Finland; Italy; Switzerland; Spain; Urinary system disease; Prostate disease; Mortality; Malignant tumor; Medical screening; European; Epidemiology; Medicine; Randomization; Male genital diseases; Prostate cancer; Public health; Cancer
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa0810084

In this trial, investigators tested the effect of prostate-specific–antigen testing on the death rate from prostate cancer in more than 162,000 men between the ages of 55 and 69 years in seven European countries. A significant reduction in prostate-cancer mortality was found after a median follow-up of 9 years. Overdiagnosis and overtreatment were important limitations of the screening program. Measurement of serum prostate-specific antigen (PSA), a biomarker for prostate cancer, 1 is useful for the detection of early prostate cancer. 2 Nevertheless, the effect of PSA-based screening on prostate-cancer mortality remains unclear. 3 The European Randomized Study of Screening for Prostate Cancer (ERSPC) was initiated in the early 1990s to determine whether a reduction of 25% in prostate-cancer mortality could be achieved by PSA-based screening. 4 Preliminary data from this study have been published and can be accessed at www.erspc.org. Another randomized screening trial in the United States, the Prostate, Lung, Colon, and Ovarian (PLCO) Cancer Screening Trial, was initiated around the same . . .