Prostate Cancer Screening Does Not Reduce All-Cause Mortality

Extended follow-up shows reduced risk of death from prostate cancer, but not overall risk of death

WEDNESDAY, March 14 (HealthDay News) -- Screening men for prostate-specific antigen (PSA) levels significantly reduces their risk of death from prostate cancer, but not their overall risk of death, according to a study in the March 15 issue of the New England Journal of Medicine.

Fritz H. Schröder, M.D., from the Erasmus University Medical Center in Rotterdam, Netherlands, and colleagues re-analyzed mortality after an additional two years of follow-up in a European study of 162,388 men (aged 55 to 69 years) who had been randomized to screening for PSA levels or no screening.

After a median of 11 years of follow-up, the researchers found a significant relative reduction in the risk of death from prostate cancer in the screened group of 21 percent, or 29 percent after correcting for selection bias and noncompliance. The relative reduction was even greater in the final two years of follow-up, at 38 percent. The absolute mortality reduction was 0.10 deaths per 1,000 person-years. However, there was no significant difference in all-cause mortality between the two groups.

"Despite the reduction in the rate of death from prostate cancer, screening had no effect on all-cause mortality," Schroder and colleagues conclude. "More information on the balance of benefits and adverse effects, as well as the cost-effectiveness, of prostate-cancer screening is needed before general recommendations can be made."

Several authors disclosed financial relationships with pharmaceutical and biotechnology companies.

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