BERKELEY, CA (UroToday.com) - Dr. Gunnar Aus and colleagues report in the March 2007 issue of European Urology that men screened for prostate cancer (CaP) had a 49% reduction in the risk of being diagnosed with metastatic disease compared to unscreened men.

The study included 10,000 men, ages 50-65 who were randomly invited for PSA screening and 10,000 randomized to serve as population-based controls. Men with a PSA >3ng/ml were asked to participate in a digital rectal examination, and transrectal ultrasound guided prostate biopsy. Those with a PSA level ›3.0ng/ml were reinvited for PSA screening after 2, 4, 6 and 8 years. All patients diagnosed with CaP were treated according to local clinical practice.

Between the years1995 and 2004, 1,252 cases of CaP were diagnosed; 810 in the screening arm and 442 in the control arm. Men randomized to active screening had a 1.83-fold increased risk of being diagnosed with CaP compared to men in the control group. Most screened men had localized disease. The number of participants with metastatic CaP at the time of diagnosis (or with a PSA >100ng/ml) was 24 in the screening group compared to 47 in the control group (p=0.0084). This represents a 49% reduction in the risk of being diagnosed with metastatic CaP by screening over a 10-year period.

The study minimized selection bias as men were randomized without any prior information. A study limitation is that men had only sextant biopsy, although the biopsies were directly laterally.

Aus G, Bergdahl S, Lodding P, Lilja H, Hugosson J.

Eur Urol. 51(3):659-664, March 2007.

UroToday.com Prostate Cancer Section

UroToday.com Advanced Prostate Cancer Treatment Center

Written by Christopher P. Evans, MD, a Contributing Editor with UroToday.

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