- PSA screening significantly reduces deaths from prostate cancer (PCa) showing larger absolute benefit with longer follow-up.
Why this matters
- Repeated screening may reduce PCa mortality on a population level.
- 16-year follow-up of the European multinational ERSPC study.
- 162,389 men (age, 55-69 years) were randomly assigned to a screening group that was offered PSA screening every 4 years or to a control group that did not receive screening.
- Funding: Hybritech Inc.
- Median follow-up: 15.5 years.
- Cumulative PCa-specific incidence was 13.3% in the screening group and 10.3% in the control group.
- Screening group had 20% lower rate of PCa mortality vs control group (rate ratio, 0.80; P<.001>
- From 13 years follow-up:
- difference in absolute PCa mortality between groups increased from 0.14% to 0.18% at 16 years,
- number needed to screen (NNS) to prevent 1 PCa death reduced from 742 to 570 years,
- number needed to diagnose (NND) decreased from 26 to 18.
- Men with PCa detected during the first round had a:
- higher prevalence of PSA >20 ng/mL vs second round (10% vs 4.1%; P<.001 and>
- higher PCa mortality (HR, 1.86; P<.001 vs subsequent rounds.>
- Uptake of opportunistic screening could underestimate the true effects of screening.