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Prostate-Cancer Mortality at 11 Years of Follow-up

Schroder, Fritz H.; Hugosson, Jonas; Roobol, Monique J.; Tammela, Teuvo L. J.; Ciatto, Stefano; Nelen, Vera; Kwiatkowski, Maciej; Lujan, Marcos; Lilja, Hans LU and Zappa, Marco, et al. (2012) In New England Journal of Medicine 366(11). p.981-990
Abstract
Background Several trials evaluating the effect of prostate-specific antigen (PSA) testing on prostate-cancer mortality have shown conflicting results. We updated prostate-cancer mortality in the European Randomized Study of Screening for Prostate Cancer with 2 additional years of follow-up. Methods The study involved 182,160 men between the ages of 50 and 74 years at entry, with a predefined core age group of 162,388 men 55 to 69 years of age. The trial was conducted in eight European countries. Men who were randomly assigned to the screening group were offered PSA-based screening, whereas those in the control group were not offered such screening. The primary outcome was mortality from prostate cancer. Results After a median follow-up of... (More)
Background Several trials evaluating the effect of prostate-specific antigen (PSA) testing on prostate-cancer mortality have shown conflicting results. We updated prostate-cancer mortality in the European Randomized Study of Screening for Prostate Cancer with 2 additional years of follow-up. Methods The study involved 182,160 men between the ages of 50 and 74 years at entry, with a predefined core age group of 162,388 men 55 to 69 years of age. The trial was conducted in eight European countries. Men who were randomly assigned to the screening group were offered PSA-based screening, whereas those in the control group were not offered such screening. The primary outcome was mortality from prostate cancer. Results After a median follow-up of 11 years in the core age group, the relative reduction in the risk of death from prostate cancer in the screening group was 21% (rate ratio, 0.79; 95% confidence interval [CI], 0.68 to 0.91; P = 0.001), and 29% after adjustment for noncompliance. The absolute reduction in mortality in the screening group was 0.10 deaths per 1000 person-years or 1.07 deaths per 1000 men who underwent randomization. The rate ratio for death from prostate cancer during follow-up years 10 and 11 was 0.62 (95% CI, 0.45 to 0.85; P = 0.003). To prevent one death from prostate cancer at 11 years of follow-up, 1055 men would need to be invited for screening and 37 cancers would need to be detected. There was no significant between-group difference in all-cause mortality. Conclusions Analyses after 2 additional years of follow-up consolidated our previous finding that PSA-based screening significantly reduced mortality from prostate cancer but did not affect all-cause mortality. (Current Controlled Trials number, ISRCTN49127736.) (Less)
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New England Journal of Medicine
volume
366
issue
11
pages
981 - 990
publisher
Massachusetts Medical Society
external identifiers
  • wos:000301482800001
  • scopus:84858212484
ISSN
0028-4793
DOI
10.1056/NEJMoa1113135
language
English
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yes
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8e79c234-20db-4f45-9f50-255e0387ce26 (old id 2517034)
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2012-05-07 07:57:35
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2017-11-05 03:11:19
@article{8e79c234-20db-4f45-9f50-255e0387ce26,
  abstract     = {Background Several trials evaluating the effect of prostate-specific antigen (PSA) testing on prostate-cancer mortality have shown conflicting results. We updated prostate-cancer mortality in the European Randomized Study of Screening for Prostate Cancer with 2 additional years of follow-up. Methods The study involved 182,160 men between the ages of 50 and 74 years at entry, with a predefined core age group of 162,388 men 55 to 69 years of age. The trial was conducted in eight European countries. Men who were randomly assigned to the screening group were offered PSA-based screening, whereas those in the control group were not offered such screening. The primary outcome was mortality from prostate cancer. Results After a median follow-up of 11 years in the core age group, the relative reduction in the risk of death from prostate cancer in the screening group was 21% (rate ratio, 0.79; 95% confidence interval [CI], 0.68 to 0.91; P = 0.001), and 29% after adjustment for noncompliance. The absolute reduction in mortality in the screening group was 0.10 deaths per 1000 person-years or 1.07 deaths per 1000 men who underwent randomization. The rate ratio for death from prostate cancer during follow-up years 10 and 11 was 0.62 (95% CI, 0.45 to 0.85; P = 0.003). To prevent one death from prostate cancer at 11 years of follow-up, 1055 men would need to be invited for screening and 37 cancers would need to be detected. There was no significant between-group difference in all-cause mortality. Conclusions Analyses after 2 additional years of follow-up consolidated our previous finding that PSA-based screening significantly reduced mortality from prostate cancer but did not affect all-cause mortality. (Current Controlled Trials number, ISRCTN49127736.)},
  author       = {Schroder, Fritz H. and Hugosson, Jonas and Roobol, Monique J. and Tammela, Teuvo L. J. and Ciatto, Stefano and Nelen, Vera and Kwiatkowski, Maciej and Lujan, Marcos and Lilja, Hans and Zappa, Marco and Denis, Louis J. and Recker, Franz and Paez, Alvaro and Maattanen, Liisa and Bangma, Chris H. and Aus, Gunnar and Carlsson, Sigrid and Villers, Arnauld and Rebillard, Xavier and van der Kwast, Theodorus and Kujala, Paula M. and Blijenberg, Bert G. and Stenman, Ulf-Hakan and Huber, Andreas and Taari, Kimmo and Hakama, Matti and Moss, Sue M. and de Koning, Harry J. and Auvinen, Anssi},
  issn         = {0028-4793},
  language     = {eng},
  number       = {11},
  pages        = {981--990},
  publisher    = {Massachusetts Medical Society},
  series       = {New England Journal of Medicine},
  title        = {Prostate-Cancer Mortality at 11 Years of Follow-up},
  url          = {http://dx.doi.org/10.1056/NEJMoa1113135},
  volume       = {366},
  year         = {2012},
}