Editorial Comment: A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer

COMMENT

This is the 16 years follow-up of the European Randomized study of Screening for Prostate Cancer (ERSPC) that was initiated in 1993 and previously published with 9, 11, and 13 years of follow-up (¹–3). This trail try to elucidate the effect of regular prostate-specific antigen (PSA) screening on prostate cancer (PCa) mortality.

This paper shows that the absolute reduction in PCa mortality still increases with longer follow-up, while the relative risk reduction remains at 20% since the initial report (¹–3). There is still a 41% excess incidence in the screening arm. The median follow-up from diagnosis is modest (8.8 years in the screening arm and 5.4 years in the control arm) given the natural course of PCa.

The number needed to diagnose for averting one PCa death was 18 in this update paper and was much higher in the previous ones.

This high level evidence publication shows that the absolute effect of screening on PCa mortality increases with longer follow-up.

REFERENCES

• ¹
  Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med. 2009;360:1320-8. Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, et al. Prostate-cancer mortality at 11 years of follow-up. N Engl J Med. 2012;366:981-90.
• ²
  Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Zappa M, Nelen V, et al. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014;384:2027-35.

Publication Dates

• Publication in this collection
  30 Mar 2020
• Date of issue
  May-Jun 2020