ㅤTake-home message from Andriole 2009, published in NEJM:
The PLCO trial assessed the effect of screening with annual PSA and digital rectal examination on mortality from prostate cancer in over 70,000 patients across 10 centres in the USA. No significant improvement in prostate cancer mortality at 7 years (rate ratio 1.13) or 10 years (rate ratio 1.11) was seen when comparing the screened group to the control (usual care) group. Screening led to a relative increase of 22% in the rate of prostate cancer diagnosis compared to the control group.
ㅤTake-home message from Andriole 2010, published in The New England Journal of Medicine (NEJM)):
In a randomised controlled trial of approximately 7,000 patients considered at increased risk of prostate cancer, the use of dutasteride at 0.5mg once daily led to a relative risk reduction in prostate cancer of 22.8% at 4 years compared to placebo. The incidence of prostate cancer was 19.9% in the dutasteride group and 25.1% in the placebo group (i.e. absolute risk reduction: 5.1%) at 4 years. No significant differences were seen between groups in the incidence of Gleason 7 to 10 disease.
ㅤTake-home message from Thompson 2003, published in The New England Journal of Medicine (NEJM)):
In the Prostate Cancer Prevention Trial, over 18,000 patients without prostate cancer were randomised to receive finasteride or placebo for seven years.
Finasteride (5mg daily) resulted in a 24.8% relative risk reduction in the prevalence of prostate cancer at 7 years.
High grade disease (Gleason 7 to 10) was noted in a higher proportion of the finasteride group (6.4%) compared to the placebo group (5.1%).
ㅤTake-home message from Jonas Hugosson 2019, published in European Urology):
Repeated PSA screening reduces the risk of dying from prostate cancer, and is more effective at detecting curable prostate cancer than one off screening which is more likely to detect incurable prostate cancer.