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Prostate Cancer Mor...
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Roobol, Monique J.
(author)
Prostate Cancer Mortality Reduction by Prostate-Specific Antigen-Based Screening Adjusted for Nonattendance and Contamination in the European Randomised Study of Screening for Prostate Cancer (ERSPC)
- Article/chapterEnglish2009
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LIBRIS-ID:oai:lup.lub.lu.se:a1cc05ff-15f9-4b8f-994c-dfc635c43836
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https://lup.lub.lu.se/record/1490065URI
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https://doi.org/10.1016/j.eururo.2009.07.018DOI
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https://gup.ub.gu.se/publication/104468URI
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Language:English
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Summary in:English
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Subject category:art swepub-publicationtype
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Subject category:ref swepub-contenttype
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Background: Prostate-specific antigen (PSA) based screening for prostate cancer (PCa) has been shown to reduce prostate specific mortality by 20% in an intention to screen (ITS) analysis in a randomised trial (European Randomised Study of Screening for Prostate Cancer [ERSPC]). This effect may be diluted by nonattendance in men randomised to the screening arm and contamination in men randomised to the control arm. Objective: To assess the magnitude of the PCa-specific mortality reduction after adjustment for nonattendance and contamination. Design, setting, and participants: We analysed the occurrence of PCa deaths during an average follow-up of 9 yr in 162 243 men 55-69 yr of age randomised in seven participating centres of the ERSPC. Centres were also grouped according to the type of randomisation (ie, before or after informed written consent). Intervention: Nonattendance was defined as nonattending the initial screening round in ERSPC. The estimate of contamination was based on PSA use in controls in ERSPC Rotterdam. Measurements: Relative risks (RRs) with 95% confidence intervals (Cis) were compared between an ITS analysis and analyses adjusting for nonattendance and contamination using a statistical method developed for this purpose. Results and limitations: In the ITS analysis, the RR of PCa death in men allocated to the intervention arm relative to the control arm was 0.80 (95% CI, 0.68-0.96). Adjustment for nonattendance resulted in a RR of 0.73 (95% CI, 0.58-0.93), and additional adjustment for contamination using two different estimates led to estimated reductions of 0.69 (95% CI, 0.51-0.92) to 0.71 (95% CI, 0.55-0.93), respectively. Contamination data were obtained through extrapolation of single-centre data. No heterogeneity was found between the groups of centres. Conclusions: PSA screening reduces the risk of dying of PCa by up to 31% in men actually screened. This benefit should be weighed against a degree of over diagnosis and overtreatment inherent in PCa screening. (C) 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved.
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Kerkhof, Melissa
(author)
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Schroeder, Fritz H.
(author)
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Cuzick, Jack
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Sasieni, Peter
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Hakama, Matti
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Stenman, Ulf Hakan
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Ciatto, Stefano
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Nelen, Vera
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Kwiatkowski, Maciej
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Lujan, Marcos
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Lilja, HansLund University,Lunds universitet,Klinisk kemi, Malmö,Forskargrupper vid Lunds universitet,Clinical Chemistry, Malmö,Lund University Research Groups(Swepub:lu)klke-hli
(author)
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Zappa, Marco
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Denis, Louis
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Recker, Franz
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Berenguer, Antonio
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Ruutu, Mirja
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Kujala, Paula
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Bangma, Chris H.
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Aus, GunnarGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
(author)
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Tammela, Teuvo L. J.
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Villers, Arnauld
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Rebillard, Xavier
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Moss, Sue M.
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de Koning, Harry J.
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Hugosson, Jonas,1955Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences(Swepub:gu)xhugjo
(author)
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Auvinen, Anssi
(author)
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Klinisk kemi, MalmöForskargrupper vid Lunds universitet
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In:European Urology: Elsevier BV56:4, s. 584-5911873-75600302-2838
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Roobol, Monique ...
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Kerkhof, Melissa
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Schroeder, Fritz ...
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Cuzick, Jack
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Sasieni, Peter
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Hakama, Matti
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Stenman, Ulf Hak ...
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Ciatto, Stefano
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Nelen, Vera
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Kwiatkowski, Mac ...
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Lujan, Marcos
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Lilja, Hans
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Zappa, Marco
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Denis, Louis
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Recker, Franz
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Berenguer, Anton ...
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Ruutu, Mirja
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Kujala, Paula
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Bangma, Chris H.
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Aus, Gunnar
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Tammela, Teuvo L ...
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Villers, Arnauld
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Rebillard, Xavie ...
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Moss, Sue M.
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European Urology
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