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Influence of blood prostate specific antigen levels at age 60 on benefits and harms of prostate cancer screening : Population based cohort study

Carlsson, Sigrid LU ; Assel, Melissa ; Sjoberg, Daniel ; Ulmert, David LU ; Hugosson Prof., Jonas ; Lilja, Hans LU orcid and Vickers, Andrew (2014) In BMJ: British Medical Journal 348.
Abstract

Objective To determine the relative risks of prostate cancer incidence, metastasis, and mortality associated with screening by serum prostate specific antigen (PSA) levels at age 60. Design Population based cohort study. Setting General male population of Sweden taking part in a screening trial in Gothenburg or participating in a cardiovascular study, the Malmo Preventive Project. Participants The screened group consisted of 1756 men aged 57.5-62.5 participating in the screening arm of the Gothenburg randomized prostate cancer screening trial since 1995. The unscreened group consisted of 1162 men, born in 1921, participating in the Malmo Preventive Project, with PSA levels measured retrospectively in stored blood samples from 1981.... (More)

Objective To determine the relative risks of prostate cancer incidence, metastasis, and mortality associated with screening by serum prostate specific antigen (PSA) levels at age 60. Design Population based cohort study. Setting General male population of Sweden taking part in a screening trial in Gothenburg or participating in a cardiovascular study, the Malmo Preventive Project. Participants The screened group consisted of 1756 men aged 57.5-62.5 participating in the screening arm of the Gothenburg randomized prostate cancer screening trial since 1995. The unscreened group consisted of 1162 men, born in 1921, participating in the Malmo Preventive Project, with PSA levels measured retrospectively in stored blood samples from 1981. Intervention PSA screening versus no screening. Main outcome measures Incidence rate ratios for the effect of screening on prostate cancer diagnosis, metastasis, and death by PSA levels at age 60. Results The distribution of PSA levels was similar between the two cohorts. Differences in benefits by baseline PSA levels were large. Among men with baseline levels measured, 71.7% (1646/2295) had a PSA level 2 ng/mL at age 60 is beneficial, with the number needed to screen and treat being extremely favourable. Screening men with a PSA level of 1-2 ng/mL is an individual decision to be based on a discussion between patient and doctor.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMJ: British Medical Journal
volume
348
article number
g2296
publisher
BMJ Publishing Group
external identifiers
  • pmid:24682399
  • wos:000333588500002
  • scopus:84897492117
ISSN
1756-1833
DOI
10.1136/bmj.g2296
language
English
LU publication?
yes
id
35dac654-07aa-4735-9ddd-71dd89991457
date added to LUP
2016-04-29 15:42:09
date last changed
2024-06-15 06:23:19
@article{35dac654-07aa-4735-9ddd-71dd89991457,
  abstract     = {{<p>Objective To determine the relative risks of prostate cancer incidence, metastasis, and mortality associated with screening by serum prostate specific antigen (PSA) levels at age 60. Design Population based cohort study. Setting General male population of Sweden taking part in a screening trial in Gothenburg or participating in a cardiovascular study, the Malmo Preventive Project. Participants The screened group consisted of 1756 men aged 57.5-62.5 participating in the screening arm of the Gothenburg randomized prostate cancer screening trial since 1995. The unscreened group consisted of 1162 men, born in 1921, participating in the Malmo Preventive Project, with PSA levels measured retrospectively in stored blood samples from 1981. Intervention PSA screening versus no screening. Main outcome measures Incidence rate ratios for the effect of screening on prostate cancer diagnosis, metastasis, and death by PSA levels at age 60. Results The distribution of PSA levels was similar between the two cohorts. Differences in benefits by baseline PSA levels were large. Among men with baseline levels measured, 71.7% (1646/2295) had a PSA level 2 ng/mL at age 60 is beneficial, with the number needed to screen and treat being extremely favourable. Screening men with a PSA level of 1-2 ng/mL is an individual decision to be based on a discussion between patient and doctor.</p>}},
  author       = {{Carlsson, Sigrid and Assel, Melissa and Sjoberg, Daniel and Ulmert, David and Hugosson Prof., Jonas and Lilja, Hans and Vickers, Andrew}},
  issn         = {{1756-1833}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ: British Medical Journal}},
  title        = {{Influence of blood prostate specific antigen levels at age 60 on benefits and harms of prostate cancer screening : Population based cohort study}},
  url          = {{http://dx.doi.org/10.1136/bmj.g2296}},
  doi          = {{10.1136/bmj.g2296}},
  volume       = {{348}},
  year         = {{2014}},
}