Prostate Cancer Screening May Reduce Mortality Risk After All

Screening for prostate cancer lowers the risk for prostate-cancer–related mortality by nearly 30%, according to a new analysis.

In their study, the researchers analyzed data from the European Randomized Study of Screening for Prostate Cancer (ERSPC) and the US Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO). Men aged 55 to 69 years in ERSPC and men aged 55 to 74 years in PLCO were randomly assigned to either screening or no screening for prostate cancer.
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Cox regression analysis, adjusted for age and trial, was used to measure prostate cancer death in each group, and extended analyses were performed to account for the mean lead time in prostate cancer diagnosis.

Analysis showed that the mean lead times between the ERSPC intervention group and the PLCO intervention group were similar, but mean lead times were longer for the PLCO control group compared with the ERSPC control group.

The extended analyses did not find differences in the effects of screening between trials. However, results showed strong evidence that the benefits of prostate cancer screening had increased with mean lead time.

Overall, screening had reduced the risk of prostate-cancer–related death by 7% to 9% per year of mean lead time. Compared with no screening, screening had reduced the risk of prostate-cancer–mortality by 25% to 31% in the ERSPC intervention group and by 27% to 32% in the PLCO intervention group.

“After differences in implementation and settings are accounted for, the ERSPC and PLCO provide compatible evidence that screening reduces prostate cancer mortality,” the researchers concluded.

—Melissa Weiss

Reference:

Tsodikov A, Gulati R, Heijnsdijk EAM, et al. Reconciling the effects of screening on prostate cancer mortality in the ERSPC and PLCO trials [published online September 5, 2017]. Ann Intern Med. doi:10.7326/M16-2586.