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Results from 22 years of Followup in the Göteborg Randomized Population-Based Prostate Cancer Screening Trial

Frånlund, Maria ; Månsson, Marianne ; Godtman, Rebecka Arnsrud ; Aus, Gunnar ; Holmberg, Erik ; Kollberg, Karin Stinesen ; Lodding, Pär ; Pihl, Carl Gustaf ; Stranne, Johan and Lilja, Hans LU orcid , et al. (2022) In Journal of Urology 208(2). p.292-300
Abstract

Purpose:Our goal was to analyze results from 22 years of followup in the Göteborg randomized prostate cancer (PC) screening trial.Materials and Methods:In December 1994, 20,000 men born 1930-1944 were randomly extracted from the Swedish population register and were randomized (1:1) into either a screening group (SG) or to a control group (CG). Men in the SG were repeatedly invited for biennial prostate specific antigen testing up to an average age of 69 years. Main endpoints were PC incidence and mortality (intention-to-screen principle).Results:After 22 years, 1,528 men in the SG and 1,124 men in the CG had been diagnosed with PC. In total, 112 PC deaths occurred in the SG and 158 in the CG. Compared with the CG, the SG showed a PC... (More)

Purpose:Our goal was to analyze results from 22 years of followup in the Göteborg randomized prostate cancer (PC) screening trial.Materials and Methods:In December 1994, 20,000 men born 1930-1944 were randomly extracted from the Swedish population register and were randomized (1:1) into either a screening group (SG) or to a control group (CG). Men in the SG were repeatedly invited for biennial prostate specific antigen testing up to an average age of 69 years. Main endpoints were PC incidence and mortality (intention-to-screen principle).Results:After 22 years, 1,528 men in the SG and 1,124 men in the CG had been diagnosed with PC. In total, 112 PC deaths occurred in the SG and 158 in the CG. Compared with the CG, the SG showed a PC incidence rate ratio (RR) of 1.42 (95% CI, 1.31-1.53) and a PC mortality RR of 0.71 (95% CI, 0.55-0.91). The 22-year cumulative PC mortality rate was 1.55% (95% CI, 1.29-1.86) in the SG and 2.13% (95% CI, 1.83-2.49) in the CG. Correction for nonattendance (Cuzick method) yielded a RR of PC mortality of 0.59 (95% CI, 0.43-0.80). Number needed to invite and number needed to diagnose was estimated to 221 and 9, respectively. PC death risk was increased in the following groups: nontesting men, men entering the program after age 60 and men with >10 years of followup after screening termination.Conclusions:Prostate specific antigen-based screening substantially decreases PC mortality. However, not attending, starting after age 60 and stopping at age 70 seem to be major pitfalls regarding PC death risk.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
epidemiology, mass screening, mortality, prostate-specific antigen, prostatic neoplasms
in
Journal of Urology
volume
208
issue
2
pages
292 - 300
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85134290929
  • pmid:35422134
ISSN
0022-5347
DOI
10.1097/JU.0000000000002696
language
English
LU publication?
yes
id
855e607f-78f9-430b-9c67-1a8873127ae4
date added to LUP
2022-09-29 09:42:52
date last changed
2024-06-13 19:44:03
@article{855e607f-78f9-430b-9c67-1a8873127ae4,
  abstract     = {{<p>Purpose:Our goal was to analyze results from 22 years of followup in the Göteborg randomized prostate cancer (PC) screening trial.Materials and Methods:In December 1994, 20,000 men born 1930-1944 were randomly extracted from the Swedish population register and were randomized (1:1) into either a screening group (SG) or to a control group (CG). Men in the SG were repeatedly invited for biennial prostate specific antigen testing up to an average age of 69 years. Main endpoints were PC incidence and mortality (intention-to-screen principle).Results:After 22 years, 1,528 men in the SG and 1,124 men in the CG had been diagnosed with PC. In total, 112 PC deaths occurred in the SG and 158 in the CG. Compared with the CG, the SG showed a PC incidence rate ratio (RR) of 1.42 (95% CI, 1.31-1.53) and a PC mortality RR of 0.71 (95% CI, 0.55-0.91). The 22-year cumulative PC mortality rate was 1.55% (95% CI, 1.29-1.86) in the SG and 2.13% (95% CI, 1.83-2.49) in the CG. Correction for nonattendance (Cuzick method) yielded a RR of PC mortality of 0.59 (95% CI, 0.43-0.80). Number needed to invite and number needed to diagnose was estimated to 221 and 9, respectively. PC death risk was increased in the following groups: nontesting men, men entering the program after age 60 and men with &gt;10 years of followup after screening termination.Conclusions:Prostate specific antigen-based screening substantially decreases PC mortality. However, not attending, starting after age 60 and stopping at age 70 seem to be major pitfalls regarding PC death risk.</p>}},
  author       = {{Frånlund, Maria and Månsson, Marianne and Godtman, Rebecka Arnsrud and Aus, Gunnar and Holmberg, Erik and Kollberg, Karin Stinesen and Lodding, Pär and Pihl, Carl Gustaf and Stranne, Johan and Lilja, Hans and Hugosson, Jonas}},
  issn         = {{0022-5347}},
  keywords     = {{epidemiology; mass screening; mortality; prostate-specific antigen; prostatic neoplasms}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{2}},
  pages        = {{292--300}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Urology}},
  title        = {{Results from 22 years of Followup in the Göteborg Randomized Population-Based Prostate Cancer Screening Trial}},
  url          = {{http://dx.doi.org/10.1097/JU.0000000000002696}},
  doi          = {{10.1097/JU.0000000000002696}},
  volume       = {{208}},
  year         = {{2022}},
}