Prostate Cancer Mortality at 11 years of Follow-up in the ERSPC

By F. Schröder, J. Hugosson, M. Roobol, T. Tammela, S. Ciatto, V. Nelen, M. Kwiatkowski, M. Luján, Hans Lilja, M. Zappa and 19 more. New England Journal of Medicine, 2012

1,267 citations recorded by the source corpus.

Summary Background Several trials have evaluated the effect of prostate-specific antigen (PSA)-based screening on prostate cancer (PC) mortality, with conflicting results. We report on the mortality in the European Randomized Trial of Screening for Prostate Cancer (ERSPC) with two added years of follow-up. Methods The ERSPC is a randomized screening trial in men aged 50 – 74 years (N=182,160) at entry, with a predefined core age group of 55 – 69 years (N=162,388) conducted in eight European countries Men randomized to the intervention arm were offered prostate specific antigen (PSA)-based screening while those in the control arm were not offered screening. The primary outcome is PC mortality. Results After a median follow-up of 11 years the relative risk reduction for PC death in the intention to screen analysis was 21% (risk ratio 0.79, 95%CI 0.68 – 0.91, p=0.001), and 29% for screened men after correction for non-compliance in the core age group. The absolute difference in mortality amounted to 0.10 per 1000 person years or 1.07 per 1000 men randomized. The rate ratio of PC mortality during the follow-up years 10 -11 was 0.62 (95% CI 0.45 – 0.85, P=0.003). The numbers needed invite (NNI) and detect (NND) to prevent one PC death amounted to 1055 and 37 at 11 years of follow-up and 936 and 33 for the entire follow-up. There was no difference in all-cause mortality. Conclusions Two added years of follow-up consolidate our previous finding that PSA-based screening reduces PC mortality but does not affect all cause mortality. (The trial is registered in the ISRCTN registry under number 49127736.)

Subfields: Oncology, Pulmonary and Respiratory Medicine

View Paper: https://www.semanticscholar.org/paper/25cbc6ab998cd9b8812396116fdbac16e80d8a42

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In Oncology

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In Pulmonary and Respiratory Medicine

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Citations in the corpus

• EAU guidelines on prostate cancer. part 1: screening, diagnosis, and local treatment with curative intent-update 2013. (2014, neutral): “In an update of the ERSCP trial, after a mean follow-up of 11 yr, the number of men needing to be screened decreased to 1055, and the number needing treatment decreased to 37 [13].”
• Early Detection of Prostate Cancer: AUA Guideline (2013, background): “Specifically, results from ERSPC document a relative risk reduction of prostate cancer specific death of 21% at a median follow-up of 11 years.(14) While the absolute reduction in prostate cancer specific mortality was relatively small (0.”
• Global Cancer Incidence and Mortality Rates and Trends—An Update (2015, methodology): “trial with a different study design did not (46, 47).”
• Genetics and biology of prostate cancer (2018, background): “Despite the widespread use of PSA screening, four out of five recent randomized clinical trials showed little or no improvement in mortality associated with aggressive treatment of inherently benign disease (Andriole et al. 2009; Schroder et al. 2009, 2012; Ilic et al. 2013).”
• Overdiagnosis and Overtreatment of Prostate Cancer (2014, methodology): “Schroder [9] ERSPC Excess cases in screened group/lives saved over 11 yr (NND) Excess incidence 37”