A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer.
Hugosson Jonas, Roobol Monique J, Månsson Marianne, Tammela Teuvo L J, Zappa Marco, Nelen Vera, Kwiatkowski Maciej, Lujan Marcos, Carlsson Sigrid V, Talala Kirsi M, Lilja Hans, Denis Louis J, Recker Franz, Paez Alvaro, Puliti Donella, Villers Arnauld, Rebillard Xavier, Kilpeläinen Tuomas P, Stenman Ulf H, Godtman Rebecka Arnsrud, Stinesen Kollberg Karin, Moss Sue M, Kujala Paula, Taari Kimmo, Huber Andreas, van der Kwast Theodorus, Heijnsdijk Eveline A, Bangma Chris, De Koning Harry J, Schröder Fritz H, Auvinen Anssi, ERSPC investigators
European urology · 2019 · PMID 30824296 · 인용 702
BACKGROUND: The European Randomized study of Screening for Prostate Cancer (ERSPC) has previously demonstrated that prostate-specific antigen (PSA) screening decreases prostate cancer (PCa) mortality.
OBJECTIVE: 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. DESIGN, SETTING, AND
PARTICIPANTS: 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. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The outcome was PCa mortality, also assessed with adjustment for nonparticipation and the number of screening rounds attended. RESULTS AND
LIMITATIONS: 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.
CONCLUSIONS: 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. PATIENT
SUMMARY: 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.