Risk of dying from prostate cancer in men randomized to screening: differences between attendees and nonattendees.
BACKGROUND
Although the true benefits and disadvantages of prostate cancer screening are still not known, the analysis of fatal cases is important for increasing knowledge of the effects of prostate cancer screening on mortality. Who dies from prostate cancer despite participation in a population-based prostate-specific antigen (PSA) screening program?


METHODS
From the Goteborg branch of the European Randomized study of Screening for Prostate Cancer, 10,000 men randomly assigned to active PSA-screening every second year formed the basis of the present study. Prostate cancer mortality was attributed to whether the men were attendees in the screening program (attending at least once) or nonattendees.


RESULTS
Thirty-nine men died from prostate cancer during the first 13 years. Both overall (34% vs 13 %; P<.0001) and cancer-specific mortality (0.8% vs 0.3 %; P<.005) were found to be significantly higher among nonattendees compared with attendees. Furthermore, the majority of deaths (12 of 18) among screening attendees were in men diagnosed at first screening (prevalent cases). Only 6 deaths (including 3 interval cases) were noted among men complying with the biennial screening program.


CONCLUSIONS
Nonattendees in prostate cancer screening constitute a high-risk group for both death from prostate cancer and death from other causes comparable to that described in other cancer screening programs.
Bergdahl
Anna Grenabo
AG
Department of Urology, Sahlgrenska University Hospital, Goteborg, Sweden. anna.grenabo@vgregion.se
Aus
Gunnar
G
Lilja
Hans
H
Hugosson
Jonas
J
D000368:Aged; D000465:Algorithms; D055088:Early Detection of Cancer; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D018570:Risk Assessment
D017430:Prostate-Specific Antigen