Screening and prostate-cancer mortality in a randomized European study.

Abstract (PubMed)

The European Randomized Study of Screening for Prostate Cancer (ERSPC) evaluated PSA testing effects on prostate cancer mortality across seven European countries. 182,000 men aged 50-74 were randomly assigned to PSA screening every 4 years or to a control group. Among the core age group of 162,243 men (55-69 years), screening achieved an 82% acceptance rate. Over 9 years median follow-up, prostate cancer cumulative incidence was 8.2% in the screened group versus 4.8% in controls. The rate ratio for prostate cancer mortality was 0.80 (95% CI, 0.65-0.98; p=0.04), representing a 20% mortality reduction. However, 48 additional cases had to be treated to prevent one death, with 1410 men needing screening per prevented death. PSA-based screening reduced the rate of death from prostate cancer by 20% but was associated with a high risk of overdiagnosis.