📃 Paper Title: A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer
🧍 Author: Jonas Hugosson
🕒 Year: 2019
📚 Journal: European Urology
🌎 Country: Sweden
ㅤContext to the study:
Can you tell me about a study that demonstrates the superiority of repeated screeening vs one-off screening at detecting curable prostate cancer?
ㅤ✅ Take-home message of study:
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.
ㅤ Multicentre population-based randomised screening trial conducted in eight European countries.
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Study participants:
182,160 men recruited from population.
Two arms: intervention group (PSA screening; n=72,890) vs. control group (n=89,351).
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Key study outcomes:
Primary outcome - prostate cancer mortality:
At 16-years, rate ratio (rate of death in intervention group divided by control group) of prostate cancer mortality was 0.80.
Difference in absolute prostate cancer mortality increased from 0.14% at 13 years to 0.18% at 16 years.
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Study Limitations:
Variable screening interval.
All men with elevated PSA offered systematic biopsy.
No MRI in pathway.
Heterogeneous populations with different background risks between centres, possibly influencing the results.
Another limitation is the increased uptake of opportunistic screening in Europe, which could underestimate the true effects of screening.
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