A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer.

The European Randomized study of Screening for Prostate Cancer (ERSPC) has previously demonstrated that prostate-specific antigen (PSA) screening decreases prostate cancer (PCa) mortality.

To determine whether PSA screening decreases PCa mortality for up to 16yr and to assess results following adjustment for nonparticipation and the number of screening rounds attended.

This multicentre population-based randomised screening trial was conducted in eight European countries. Report includes 182160 men, followed up until 2014 (maximum of 16yr), with a predefined core age group of 162389 men (55-69yr), selected from population registry.

The outcome was PCa mortality, also assessed with adjustment for nonparticipation and the number of screening rounds attended.

The rate ratio of PCa mortality was 0.80 (95% confidence interval [CI] 0.72-0.89, p<0.001) at 16yr. The difference in absolute PCa mortality increased from 0.14% at 13yr to 0.18% at 16yr. The number of men needed to be invited for screening to prevent one PCa death was 570 at 16yr compared with 742 at 13yr. The number needed to diagnose was reduced to 18 from 26 at 13yr. Men with PCa detected during the first round had a higher prevalence of PSA >20ng/ml (9.9% compared with 4.1% in the second round, p<0.001) and higher PCa mortality (hazard ratio=1.86, p<0.001) than those detected subsequently.

Findings corroborate earlier results that PSA screening significantly reduces PCa mortality, showing larger absolute benefit with longer follow-up and a reduction in excess incidence. Repeated screening may be important to reduce PCa mortality on a population level.

In this report, we looked at the outcomes from prostate cancer in a large European population. We found that repeated screening reduces the risk of dying from prostate cancer.

European urology. 2019 Feb 26 [Epub ahead of print]

Jonas Hugosson, Monique J Roobol, Marianne Månsson, Teuvo L J Tammela, Marco Zappa, Vera Nelen, Maciej Kwiatkowski, Marcos Lujan, Sigrid V Carlsson, Kirsi M Talala, Hans Lilja, Louis J Denis, Franz Recker, Alvaro Paez, Donella Puliti, Arnauld Villers, Xavier Rebillard, Tuomas P Kilpeläinen, Ulf H Stenman, Rebecka Arnsrud Godtman, Karin Stinesen Kollberg, Sue M Moss, Paula Kujala, Kimmo Taari, Andreas Huber, Theodorus van der Kwast, Eveline A Heijnsdijk, Chris Bangma, Harry J De Koning, Fritz H Schröder, Anssi Auvinen, ERSPC investigators

Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Göteborg, Göteborg, Sweden. Electronic address: ., Erasmus Medical Centre, Rotterdam, The Netherlands., Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Göteborg, Göteborg, Sweden., University of Tampere, Faculty of Medicine and Life Sciences, Tampere, Finland., ISPRO, Oncological network, Prevention, and Research Institute, Florence, Italy., Provinciaal Instituut voor Hygiëne, Antwerp, Belgium., Department of Urology, Cantonal Hospital Aarau, Aarau, Switzerland; Department of Urology, Academic Hospital Braunschweig, Braunschweig, Germany., Urology Department, Hospital Infanta Cristina, Parla, Madrid, Spain., Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Göteborg, Göteborg, Sweden; Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Finnish Cancer Registry, Helsinki, Finland., Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Department of Translational Medicine, Lund University, Skåne University Hospital, Malmö, Sweden., Europa Uomo, Oncology Centre Antwerp, Antwerp, Belgium., Department of Urology, Cantonal Hospital Aarau, Aarau, Switzerland., Department of Urology, Hospital Universitario de Fuenlabrada, Madrid, Spain., Department of Urology, CHU Lille, University Lille Nord de France, Lille, France., Urology Department, Clinique Beau Soleil, Montpellier, France., Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland., Department of Pathology, Fimlab Laboratories, Tampere, Finland., Centre for Cancer Prevention, Wolfson Institute of Preventative Medicine, Queen Mary University of London, Charterhouse Square, UK., Department of Laboratory Medicine, Cantonal Hospital Aarau, Aarau, Switzerland., Laboratory Medicine Program, University Health Network, Toronto, Canada., Erasmus Medical Centre, Department of Public Health, Rotterdam, The Netherlands., Prostate Cancer Research Center, Faculty of Social Sciences, University of Tampere, Tampere, Finland.

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