title: Screening decreases prostate cancer mortality: 11-year follow-up of the 1988 Quebec prospective randomized controlled trial.
abstract: OBJECTIVE
  This clinical trial is aimed at evaluating the impact of prostate cancer screening on cancer-specific mortality.
  
  
  METHODS
  Forty-six thousand four hundred and eighty-six (46,486) men aged 45-80 years registered in the electoral roll of the Quebec city area were randomized in 1988 between screening and no screening. Screening included measurement of serum prostatic specific antigen (PSA) using 3.0 ng/ml as upper limit of normal and digital rectal examination (DRE) at first visit. At follow-up visits, serum PSA only was used.
  
  
  RESULTS
  Seventy-four (74) deaths from prostate cancer occurred in the 14,231 unscreened controls while 10 deaths were observed in the screened group of 7,348 men during the first 11 years following randomization. Median follow-up of screened men was 7.93 years. A Cox proportional hazards model of the age at death from prostate cancer shows a 62% reduction (P < 0.002, Fisher's exact test) of cause-specific mortality in the screened men (P = 0.005). These results are in agreement with the continuous decrease of prostate cancer mortality observed in North America.
authors.affiliation: Oncology and Molecular Endocrinology Research Center and Departments of Medicine and Radiology, Laval University Medical Center (CHUL), and Laval University, Quebec, Canada. fernand.labrie@crchul.ulaval.ca
authors.forename: Fernand
authors.initials: F
authors.lastname: Labrie
authors.forename: Bernard
authors.initials: B
authors.lastname: Candas
authors.forename: Lionel
authors.initials: L
authors.lastname: Cusan
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Gomez
authors.forename: Alain
authors.initials: A
authors.lastname: Bélanger
authors.forename: G
authors.initials: G
authors.lastname: Brousseau
authors.forename: Eric
authors.initials: E
authors.lastname: Chevrette
authors.forename: Jacques
authors.initials: J
authors.lastname: Lévesque
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D010808:Physical Examination; D017430:Prostate-Specific Antigen / Q000032:analysis*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D011792:Quebec / Q000453:epidemiology; D012007:Rectum / Q000473:pathology; D012042:Registries / Q000706:statistics & numerical data*; D016019:Survival Analysis
chemical_list: D017430:Prostate-Specific Antigen