Confirmed Drop in Prostate Cancer Deaths From PSA Screening

Increased absolute effect at 13 years compared with findings at nine and 11 years.
Increased absolute effect at 13 years compared with findings at nine and 11 years.

Prostate-specific antigen (PSA) screening is associated with a lasting reduction in prostate cancer mortality, with increased effect at 13 years compared with nine or 11 years, according to a study published online in The Lancet.

Fritz H. Schröder, M.D., from the Erasmus University Medical Center in Rotterdam, Netherlands, and colleagues provided updated results of prostate cancer mortality from the European Randomised study of Screening for Prostate Cancer (ERSPC). The multicenter, randomized trial assessed PSA testing in eight European countries for eligible men aged 50 to 74 years. Data were truncated at 13 years.

The researchers found that for the intervention versus the control group the rate ratio for prostate cancer incidence was 1.91 after nine years (1.64 including France), 1.66 after 11 years, and 1.57 after 13 years.

After nine, 11, and 13 years, the rate ratio of mortality was 0.85 (95 percent confidence interval [CI], 0.70 to 1.03), 0.78 (95 percent CI, 0.66 to 0.91), and 0.79 (95 percent CI, 0.69 to 0.91), respectively. At 13 years, the absolute risk reduction of death from prostate cancer was 0.11 per 1,000 person-years or 1.28 per 1,000 men randomized.

"In this update the ERSPC confirms a substantial reduction in prostate cancer mortality attributable to testing of PSA, with a substantially increased absolute effect at 13 years compared with findings after nine and 11 years," the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry; several authors disclosed holding patents relating to PSA.

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