Prostate cancer screening: what we have learned from the PLCO and ERSPC trials.
Two large randomized trials on prostate cancer screening have recently reported their 10-year results with somewhat differing conclusions. The Prostate, Lung, Colorectal, and Ovarian Cancer Screening (PLCO) study found a slightly higher risk of a prostate cancer diagnosis in the screening cohort, but no cancer-specific survival advantage was seen for this group. However, the study had widespread screening contamination in the control arm that significantly weakens the study's ability to reach a valid conclusion about the benefits of screening. The European Randomized Study of Screening in Prostate Cancer (ERSPC) was less affected by screening contamination of the control arm, and a cancer-specific survival benefit for the screening arm was seen by 7-8 years (RR, 0.70-0.80). Based on these studies, it is reasonable to conclude that there is a survival benefit for screening, but it may not extend to older men (>75 years) who have undergone prior screening.
La Rochelle
Jeffrey
J
Department of Surgery, Division of Urology, Oregon Health and Sciences University, 3303 SW Bond Avenue, Mail Code CH10U, Portland, OR, 97239, USA. larochel@ohsu.edu
Amling
Christopher L
CL
D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D015996:Survival Rate; D014481:United States / Q000453:epidemiology
D017430:Prostate-Specific Antigen