PSA screening significantly decreases the risk of developing metastatic prostate cancer (PCa), according to findings from the European Randomized Study of Screening for Prostate Cancer (ERSPC).

Men randomly assigned to a group to which regular PSA screening is offered had a 30% reduction in the relative risk of metastatic PCa compared with men assigned to a group not offered such screening (controls), investigators reported online in European Urology. The relative risk reduction was 42% among men who actually were screened.

Fritz H. Schröder, MD, of Erasmus Medical Center in Rotterdam, The Netherlands, and collaborators analyzed data from 76,813 men aged 55-69 years. Over a median follow-up of 12 years, investigators identified 666 men with metastatic PCa: 256 in the screening arm and 410 in the control arm, for a cumulative incidence of 0.67% and 0.86% per 1,000 men, respectively.

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The investigators noted that the reduction metastatic disease must be balanced against the downside of screening, primarily the rate of overdiagnosis in the screening arm, which they estimated to be at least 50% in the setting of the ERSPC.