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PSA Program Linked to Less Prostate Cancer Mortality

Rate ratio of death from prostate cancer in men attending screenings versus controls was 0.44

THURSDAY, July 1 (HealthDay News) -- A prostate-specific antigen (PSA)-based screening program is associated with a reduction in prostate cancer mortality of nearly half over 14 years, but with a substantial risk of overdiagnosis, according to research published online July 1 in The Lancet Oncology.

Jonas Hugosson, M.D., of the University of Göteborg in Sweden, and colleagues analyzed data from 20,000 men aged 50 to 64 who were randomized to a group invited for PSA testing every two years or a control group. Of the screening group, 7,578 men attended at least once.

The researchers found that the cumulative prostate-cancer incidence over a median 14 years was 12.7 percent in the screening group and 8.2 percent in the control group. At 14 years, the absolute cumulative risk reduction of death from prostate cancer was 0.40 percent (0.90 percent in the control group and 0.50 percent in the screening group). The rate ratio for death from prostate cancer for attendees compared with the control group was 0.44. Twelve men needed to be diagnosed, and 293 invited for screening, to prevent one prostate cancer death.

"In summary, in this trial, prostate-cancer screening was well accepted by the general population and can result in a relevant reduction in cancer mortality, greater than that reported in screening for breast or colorectal cancer. Nevertheless, PSA screening is associated with a long and varying lead time, resulting in a risk of overdiagnosis that is substantial but still of a largely unknown magnitude," the authors conclude.

Two co-authors disclosed related patents and/or relationships with pharmaceutical companies.

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