Prostate-cancer mortality at 11 years of follow-up

Fritz H. Schröder, Jonas Hugosson, Monique J. Roobol, Teuvo L J Tammela, Stefano Ciatto, Vera Nelen, Maciej Kwiatkowski, Marcos Lujan, Pekka Karhunen, Hans Lilja, Teemu Murtola, Marco Zappa, Louis J. Denis, Franz Recker, Alvaro Páez, Liisa Määttänen, Chris H. Bangma, Gunnar Aus, Sigrid Carlsson, Arnauld VillersXavier Rebillard, Theodorus Van Der Kwast, Paula M. Kujala, Bert G. Blijenberg, Ulf Hakan Stenman, Andreas Huber, Kimmo Taari, Matti Hakama, Sue M. Moss, Harry J. De Koning, Anssi Auvinen

Research output: Contribution to journalArticleScientificpeer-review

1060 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)981-990
Number of pages10
JournalThe New England Journal of Medicine
Volume366
Issue number11
DOIs
Publication statusPublished - 2012
Publication typeA1 Journal article-refereed

Publication forum classification

  • Publication forum level 3

Fingerprint

Dive into the research topics of 'Prostate-cancer mortality at 11 years of follow-up'. Together they form a unique fingerprint.

Cite this