Prostate-cancer mortality at 11 years of follow-up
Fritz H Schröder, Jonas Hugosson, Monique J Roobol, Teuvo L J Tammela, Stefano Ciatto, Vera Nelen, Maciej Kwiatkowski, Marcos Lujan, Hans Lilja, Marco Zappa, Louis J Denis, Franz Recker, Alvaro Páez, Liisa Määttänen, Chris H Bangma, Gunnar Aus, Sigrid Carlsson, Arnauld Villers, Xavier Rebillard, Theodorus van der Kwast, Paula M Kujala, Bert G Blijenberg, Ulf-Hakan Stenman, Andreas Huber, Kimmo Taari, Matti Hakama, Sue M Moss, Harry J de Koning, Anssi Auvinen, ERSPC Investigators, W J Kirkels, J B W Rietbergen, I W van der Cruijsen, R Raaijmakers, S H de Vries, S Roemeling, C Gosselaar, T Wolters, R C N van den Bergh, P J van Leeuwen, M Bul, X Zhu, H A van Vugt, G Yurdakul, A Boeken-Kruger, C Wijburg, M Forouzanfor, M de Boer, R Postma, A N Vis, R Hoedemaeker, A van Leenders, R van Schaik, P J van der Maas, S Otto, G Draisma, P Beemsterboer, M Essink-Bot, I Korfage, R Boer, M Wildhagen, E Heijnsdijk, W Merkelbach, W Hoekstra, J Blom, R A M Damhuis, A Reedijk, R Kranse, D W Roobol, W Roobol, E van den Berg, G-J de Zwart, C G A M Franken-Raab, M van Slooten-Midderig, A Smit, V van der Drift, E de Bilde, L Mani, M Visser-van Dongen, H Versteeg-Leenheer, B Zoutendijk, N Vink, H van Meurs, A E de Bruijn, L D F Venderbos, H Devriendt, G Thijs, A Hermans, K D'Hooge, H Neels, A Wauters, I Neetens, M Kockx, F Keuppens, J Braeckman, F Govaerts, B Spinnewijn, M Van Hoey, T Putzeys, M De Coninck, B Dourcy-Belle-Rose, A Vancauwenbergh, J W Coebergh, H Verhaegen, Van Vliet, B Standaert, L Van Herck, Maria Nyberg, Svante Bergdahl, Pär Lodding, Ali Khatami, Johan Stranne, Helén Ahlgren, Gun-Britt Eriksson, Charlotte Becker, Sigrid Carlsson, Anna Grenabo, Silas Pettersson, Eberhard Varenhorst, Bo-Johan Norlén, Björn Zackrisson, Erik Holmberg, Roland Frösing, Erik Pileblad, Carl-Gustaf Pihl, Marita Laurila, Mirja Ruutu, Jussi Aro, Harri Juusela, Markus Mildh, Jorma Lahtela, Pekka J Karhunen, Tuukka Mäkinen, Antti Rannikko, Nea Malila, Tuomas Kilpeläinen, Teemu Murtola, Sanna Kuivalainen, Tiina Karhunen, Mario Cappellini, Simonetta Bianchi, Claudio Lombardi, Alessandro Bussotti, Paolo Bastiani, Rita Bonardi, Antonia Mazzotta, Dusca Bartoli, Liana Bonfrisco, Emanuele Crocetti, Francesca Martinelli, Paola Zendron, Paola Frullini, Simonetta Di Lollo, Tiziana Rubeca, Antonio Berenguer, Jose A Rodriguez, Benita Aybar, Daniel Seiler, Martin Baumgartner, Reto Tscholl, Elsbeth Woodtli, Lydia Schärer, Roberto Herklotz, Bernhard Stamm, Martin Wernli, Stephan Bodis, Rainer Grobholz, Lukas Bubendorf, Kurt Lehmann, Hans-Ruedi Schmid, Hans-Ulrich Iselin, Johann Steurer, Michael Kurrer, Bernard Malavaud, François Iborra, Sandra Malavaud, Pascale Grosclaude, Brigitte Tretarre, Vincent Bataille, Faiza Bessaoud, J Hemming, P Coulson, D Coleman, Th Van der Kwast, G J van Leenders, R F Hoedemaeker, C-G Pihl, P M Martikainen, M Laurila, L Bubendorf, C Santonja, I Neetens, S DiLollo, C Mazerolles, C Lopes, Fritz H Schröder, Jonas Hugosson, Monique J Roobol, Teuvo L J Tammela, Stefano Ciatto, Vera Nelen, Maciej Kwiatkowski, Marcos Lujan, Hans Lilja, Marco Zappa, Louis J Denis, Franz Recker, Alvaro Páez, Liisa Määttänen, Chris H Bangma, Gunnar Aus, Sigrid Carlsson, Arnauld Villers, Xavier Rebillard, Theodorus van der Kwast, Paula M Kujala, Bert G Blijenberg, Ulf-Hakan Stenman, Andreas Huber, Kimmo Taari, Matti Hakama, Sue M Moss, Harry J de Koning, Anssi Auvinen, ERSPC Investigators, W J Kirkels, J B W Rietbergen, I W van der Cruijsen, R Raaijmakers, S H de Vries, S Roemeling, C Gosselaar, T Wolters, R C N van den Bergh, P J van Leeuwen, M Bul, X Zhu, H A van Vugt, G Yurdakul, A Boeken-Kruger, C Wijburg, M Forouzanfor, M de Boer, R Postma, A N Vis, R Hoedemaeker, A van Leenders, R van Schaik, P J van der Maas, S Otto, G Draisma, P Beemsterboer, M Essink-Bot, I Korfage, R Boer, M Wildhagen, E Heijnsdijk, W Merkelbach, W Hoekstra, J Blom, R A M Damhuis, A Reedijk, R Kranse, D W Roobol, W Roobol, E van den Berg, G-J de Zwart, C G A M Franken-Raab, M van Slooten-Midderig, A Smit, V van der Drift, E de Bilde, L Mani, M Visser-van Dongen, H Versteeg-Leenheer, B Zoutendijk, N Vink, H van Meurs, A E de Bruijn, L D F Venderbos, H Devriendt, G Thijs, A Hermans, K D'Hooge, H Neels, A Wauters, I Neetens, M Kockx, F Keuppens, J Braeckman, F Govaerts, B Spinnewijn, M Van Hoey, T Putzeys, M De Coninck, B Dourcy-Belle-Rose, A Vancauwenbergh, J W Coebergh, H Verhaegen, Van Vliet, B Standaert, L Van Herck, Maria Nyberg, Svante Bergdahl, Pär Lodding, Ali Khatami, Johan Stranne, Helén Ahlgren, Gun-Britt Eriksson, Charlotte Becker, Sigrid Carlsson, Anna Grenabo, Silas Pettersson, Eberhard Varenhorst, Bo-Johan Norlén, Björn Zackrisson, Erik Holmberg, Roland Frösing, Erik Pileblad, Carl-Gustaf Pihl, Marita Laurila, Mirja Ruutu, Jussi Aro, Harri Juusela, Markus Mildh, Jorma Lahtela, Pekka J Karhunen, Tuukka Mäkinen, Antti Rannikko, Nea Malila, Tuomas Kilpeläinen, Teemu Murtola, Sanna Kuivalainen, Tiina Karhunen, Mario Cappellini, Simonetta Bianchi, Claudio Lombardi, Alessandro Bussotti, Paolo Bastiani, Rita Bonardi, Antonia Mazzotta, Dusca Bartoli, Liana Bonfrisco, Emanuele Crocetti, Francesca Martinelli, Paola Zendron, Paola Frullini, Simonetta Di Lollo, Tiziana Rubeca, Antonio Berenguer, Jose A Rodriguez, Benita Aybar, Daniel Seiler, Martin Baumgartner, Reto Tscholl, Elsbeth Woodtli, Lydia Schärer, Roberto Herklotz, Bernhard Stamm, Martin Wernli, Stephan Bodis, Rainer Grobholz, Lukas Bubendorf, Kurt Lehmann, Hans-Ruedi Schmid, Hans-Ulrich Iselin, Johann Steurer, Michael Kurrer, Bernard Malavaud, François Iborra, Sandra Malavaud, Pascale Grosclaude, Brigitte Tretarre, Vincent Bataille, Faiza Bessaoud, J Hemming, P Coulson, D Coleman, Th Van der Kwast, G J van Leenders, R F Hoedemaeker, C-G Pihl, P M Martikainen, M Laurila, L Bubendorf, C Santonja, I Neetens, S DiLollo, C Mazerolles, C Lopes
Abstract
Background: Several trials evaluating the effect of prostate-specific antigen (PSA) testing on prostate-cancer mortality have shown conflicting results. We updated prostate-cancer mortality in the European Randomized Study of Screening for Prostate Cancer with 2 additional years of follow-up.
Methods: The study involved 182,160 men between the ages of 50 and 74 years at entry, with a predefined core age group of 162,388 men 55 to 69 years of age. The trial was conducted in eight European countries. Men who were randomly assigned to the screening group were offered PSA-based screening, whereas those in the control group were not offered such screening. The primary outcome was mortality from prostate cancer.
Results: After a median follow-up of 11 years in the core age group, the relative reduction in the risk of death from prostate cancer in the screening group was 21% (rate ratio, 0.79; 95% confidence interval [CI], 0.68 to 0.91; P=0.001), and 29% after adjustment for noncompliance. The absolute reduction in mortality in the screening group was 0.10 deaths per 1000 person-years or 1.07 deaths per 1000 men who underwent randomization. The rate ratio for death from prostate cancer during follow-up years 10 and 11 was 0.62 (95% CI, 0.45 to 0.85; P=0.003). To prevent one death from prostate cancer at 11 years of follow-up, 1055 men would need to be invited for screening and 37 cancers would need to be detected. There was no significant between-group difference in all-cause mortality.
Conclusions: Analyses after 2 additional years of follow-up consolidated our previous finding that PSA-based screening significantly reduced mortality from prostate cancer but did not affect all-cause mortality. (Current Controlled Trials number, ISRCTN49127736.).
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Source: PubMed