VIENNA—PSA screening for prostate cancer (PCa) decreases the risk of PCa-related metastatic disease, according to study findings presented at the European Association of Urology 26th annual congress.
The finding emerged from a study of 35,153 men aged 55-69 years who were randomized to receive systematic PSA screening (intervention arm) or usual care (control arm) as part of the European Randomized Study of Screening for Prostate Cancer section in Rotterdam, The Netherlands.
Fritz H. Schröder, MD, and colleagues at Erasmus University Medical Centre in Rotterdam followed all men for a PCa diagnosis and PCa distant metastases up to December 31, 2008. They determined the presence of distant metastases by a positive isotope bone scan or by a serum PSA level of 100 ng/mL or greater in case an isotope bone scan was not performed.
As of the end of 2008, PCa was diagnosed in 2,036 men (11.6%) in the intervention arm and 902 (5.1%) of the control arm. The rate of PCa metastases was 0.62 men per 1,000 person-years in the intervention arm and 0.88 per 1,000 person-years in the control arm.
Compared with the control arm, the intervention arm had a 30% decreased relative risk of metastatic disease, Dr. Schröder reported. The cumulative risk of PCa metastases started to differ after five years of observation and became statistically significant more than seven years after the start of observation.
After a median of 11 years, the absolute reduction in PCa metastasis risk was 2.80 metastases per 1,000 men.
Dr. Schröder told listeners that 357 men needed to be screened and 23 needed to be treated to prevent PCa metastasis in one man.
He and his colleagues concluded that longer follow-up is likely to show an increasing benefit of PSA screening in terms of distant metastases.