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Screening failed to affect rate of prostate cancer death in Scandinavian men
Sandblom G. BMJ. 2011;doi:10.1136/bmj.d1539.
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Twenty-year results of a population-based, randomized controlled trial showed that the rate of prostate cancer-specific death did not differ significantly between men who were screened and those who were not.
In 1987, 1,494 men aged 50 to 69 years in Norrköping, Sweden, were randomly selected to undergo prostate cancer screening once every 3 years until 1996. The control group consisted of 7,532 men.
Men in the experimental group were examined with digital rectal exam only in the first two screenings, then by digital rectal exam and PSA for their third and fourth screens. Between 70% and 78% appeared at the four individual screenings.
Median follow-up was 75 months. There were 85 diagnosed cases of prostate cancer (5.7%) in the screening group and 292 (3.9%) in the control group.
Thirty men (35%) in the screening group and 130 (45%) in the control group died of prostate cancer. Overall mortality was 81% in the screening group vs. 86% in the control group. Median cancer-specific survival was 201 months in the screened group and 133 months in the control group.
Sandblom and colleagues said neither prostate cancer survival (HR=1.23; 95% CI, 0.94-1.62) nor OS (HR=1.58; 95% CI, 1.06-2.36) was superior in the screening group after adjusting for age at intake. The risk ratio for death from prostate cancer was 1.16 (95% CI, 0.78-1.73).
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