Abstract
The impact of screening on prostate cancer mortality is still unknown. A favourable
impact is suggested by uncontrolled and possibly biased studies. Mortality from all
causes and from prostate cancer was assessed in a cohort of 6861 males aged 60–74
years, participants to a pilot screening study during 1991–1994. Observed/expected
mortality was determined by linkage with cancer and mortality registries. Prostate
cancer standardised mortality rate (SMR) in the overall series (751 subjects excluded
by GPs for disabling illness or prostate cancer; 3448 refusers, 2662 attenders; 67,321.2
men-year) was 0.96 (95% confidence interval (CI) = 0.74–1.22) when deaths from prevalent cancers diagnosed before screening were considered.
Reduced prostate cancer mortality (SMR = 0.48; 95% CI = 0.26–0.83), persisting beyond five years after study entry (SMR = 0.48; 95% CI = 0.22–0.90), was observed in attenders and not in refusers (SMR = 0.99; 95% CI = 0.69–1.37). This finding might suggest a screening effect, but might also be ascribed
to an healthy screening effect, and cannot be assumed as a reliable evidence of screening
efficacy.
Keywords
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References
- Prostate cancer mortality after introduction of prostate-specific antigen mass screening in the Federal State of Tyrol, Austria.Urology. 2001; 58: 417-424
- Screening for prostate cancer: updated experience from the Tyrol study.Curr Urol Rep. 2004; 5: 220-225
- Screening decreases prostate cancer death: first analysis of the 1988 Quebec prospective randomized controlled trial.Prostat. 1999; 38: 83-91
- Screening decreases prostate cancer mortality: 11-year follow-up of the 1988 Quebec prospective randomized controlled trial.Prostate. 2004; 59: 311-318
- Quebec randomized controlled trial on prostate cancer screening shows no evidence for mortality reduction.Prostate. 1999; 40: 130-134
- Reply to Labrie et al. Results of the mortality analysis of the Quebec randomized/controlled trial (RCT).Prostate. 1999; 40: 135-137
- Does PSA screening reduce prostate cancer mortality?.CMAJ. 2002; 166: 600-601
- Cancer surveillance series: interpreting trends in prostate cancer – part II: cause of death misclassification and the recent rise and fall in prostate cancer mortality.J Natl Cancer Inst. 1999; 91: 1025-1032
- International trends in prostate-cancer mortality in the “PSA ERA”.Int J Cancer. 2001; 92: 893-898
- Rotterdam randomized pilot studies of screening for prostate cancer – an overview after 10 years.J Natl Cancer Inst. 2005; 97: 696
- Rationale for randomised trials of prostate cancer screening.Eur J Cancer. 1999; 35: 262-271
- Large-scale randomized prostate cancer screening trials; program performance in the ERSPC and PLCO trials.Int J Cancer. 2002; 97: 237-244
- Lead times and overdetection due to prostate-specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer.J Natl Cancer Inst. 2003; 95: 868-878
- Overdiagnosis of prostate carcinoma by screening: an estimate based on the results of the Florence Screening Pilot Study.Ann Oncol. 1998; 9: 1297-1300
- Prostate cancer screening: the problem of overdiagnosis and lessons to be learned from breast cancer screen.Eur J Cancer. 2000; 36: 1347-1350
- The role of prostate specific antigen (PSA) testing pattern in the recent prostate cancer incidence decline in the United States.Cancer Causes and Control. 1998; 9: 519-527
- Determination of county-level prostate carcinoma incidence and detection rates with Medicare claims data.Cancer. 2001; 92: 102-109
- Prostate cancer incidence and mortality in the United States and the United Kingdom.J Natl Cancer Inst. 2001; 93: 1109-1110
- Comparing two modalities of screening for prostate cancer: digital rectal examination + transrectal ultrasonography vs. prostate specific antigen.Tumori. 1995; 81: 225-229
- Determining overdiagnosis by screening with DRE/TRUS or PSA (Florence pilot studies, 1991–1994).Eur J Cancer. 2005; 41: 411-415
- Tuscany Cancer Registry.in: Cancer Incidence in Five Continents. vol. VIII. IARC Scientific Publications n. 155, Lyon2002
- Prostate cancer and prostate specific antigen (PSA) screening in Austria.Wien Klin Wochenscr. 2005; 117: 457-461
Article info
Publication history
Accepted:
January 17,
2006
Received in revised form:
January 13,
2006
Received:
December 5,
2005
Identification
Copyright
© 2006 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
