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Prostate-Cancer Mortality at 11 Years of Follow-up

21st March 2012: It has been known for a number of years now that prostate cancer deaths can be reduced by PSA testing


"It has been known for a number of years now that prostate cancer deaths can be reduced by PSA testing. The best of these studies carried out internationally is the European Randomised Study of Screening for Prostate Cancer led by Fritz Schroder from Rotterdam. The initial results were published several years ago in the New England Journal of Medicine; and a further sub-group analysis was published in The Lancet Oncology two years from the Göteborg part of the screening programme.

The recent update of this study has just been published in the New England Journal of Medicine (March 2012). In brief the European Study has involved over 180,000 men who were randomly assigned to a control group and those who were offered PSA testing.

After a follow up period of 11 years in the screening group there was a reduction in death from prostate cancer by 20%. To prevent one death from prostate cancer after 11 years of follow up over 1,000 men would need to be invited for screening and 37 men wth cancer would need to be treated. The latest study has confirmed these early findings and demonstrates that PSA testing does indeed detect prostate cancers at an earlier stage and it does reduce death from prostate cancer.

There remain a number of questions however, in that PSA testing continues to detect a number of cancers that are a very low future risk to patients and continued work is required to detect better biomarkers and genetic markers to identify populations and individuals at high risk of developing the serious forms of prostate cancer that can cause death."

Professor David Neal
Clinical Director – ProstateHealth UK

The reference to the article is 'n engl j med 366;11 nejm.org march 15, 2012'  and the on-line link is http://www.nejm.org/doi/full/10.1056/NEJMoa1113135.

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