"European Randomized Study of Screening for Prostate Cancer (ERSPC)". The New England Journal of Medicine. 2009. 360(13):1320-1328. PubMed
Links to original sources: Wiki Journal Post Full Journal Article
Does PSA-based screening reduce the mortality from prostate cancer in men aged 50-74 years?
PSA-based screening reduced the rate of death from prostate cancer by 20% but was associated with a high risk of overdiagnosis.
The European Randomized Study of Screening for Prostate Cancer (ERSPC) was designed to determine whether PSA-based screening could lead to a significant reduction in prostate-cancer mortality. Conducted over a median follow-up of 9 years among men aged 50-74, the study found a 20% relative reduction in the rate of death from prostate cancer among men aged 55-69 at study entry. However, a substantial number of men needed to be screened (1410) and additional cases treated (48) to prevent one prostate cancer death.
The ERSPC does not directly create guidelines but offers critical data for informing prostate cancer screening decisions.
- Multicenter, randomized control trial - N=182,000 men (ages 50-74) identified through registries in seven European countries - Intervention: Offered PSA screening every 4 years; control: No screening - Core age group: 162,243 men (ages 55-69 years) - Median follow-up: 9 years - Primary outcome: Rate of death from prostate cancer, with follow-up ending December 31, 2006
- Inclusion Criteria: Men ages 50 to 74 years - Exclusion Criteria: Men with diagnosed prostate cancer - Baseline Characteristics: Mean age was 60.8 years
- Screening group offered PSA tests average once every 4 years; various interventions like biopsies based on elevated PSA values
- Primary Outcome: Rate of death from prostate cancer - 0.80 (95% CI, 0.65 to 0.98; adjusted P=0.04) rate ratio for death from prostate cancer in the screening group - To prevent one death from prostate cancer, 1,410 men needed to be screened and 48 additional prostate cancer cases needed to be treated - Secondary Outcomes: Not discussed in the provided abstract
- Overdiagnosis and subsequent treatment of indolent cancers that might not impact longevity or quality of life - The significant number of men requiring screening and treatment to prevent one prostate cancer death, indicating overtreatment potential
- Funded by grants from Europe Against Cancer, European Union framework programs, agencies or health authorities of the participating countries, alongside unconditional grants from Beckman Coulter
- "Screening and Prostate-Cancer Mortality in a Randomized European Study", New England Journal of Medicine - PSA-based Prostate Cancer Screening - Long-term Follow-up of ERSPC Trials