Incidence and mortality of PCa after termination of PSA-based screening

Men who participate in biennial PSA based screening have a lower risk of being diagnosed as well as dying from prostate cancer up to 9 years after their last PSA test, according to the results of a new study to be presented at the 28th Annual EAU Congress in Milan

A joint Swedish-UK study aimed to examined the risk of developing after last invitation to . This investigation follows up on previous publication from the Göteborg randomized screening trial (part of ERSPC) by the same group which showed that biennial lowered PC mortality with 44%

In the course of the study, which launched in 1995, 20000 men were randomized and 9 952 have been invited every second year for PSA testing while 9952 were randomized to a control arm. All cases of prostate cancer in the screening (n= 6449) as well as the control arm (n= 6974) after reaching the upper age limit for invitation (median 69 range 67-71 years) were identified by matching with the Regional Cancer Register in western Sweden.

For all deaths in men with prostate cancer, a review of cause of was performed by an independent committee, the date of follow-up being 30 June 2012 or at a maximum of 12 years. PCs diagnosed were classified into low, intermediate or high/advanced risk groups and all attendees were defined as participating at least once

In the course of the study, a total of 173 men with were diagnosed with prostate cancer in the invited arm (with a median follow-up of 4.8 years) and 371 were diagnosed in the control arm (with a median follow-up of 4.9 years).

Up to 9 years after last invitation all risk groups were more commonly diagnosed in the control arm but after 9 years the rates in the screening arm caught up, other than those for the low . In the invited arm, non-attendees had an incidence similar to that of the control arm. Also mortality in PC was lower in the screening arm up to 9 years, which is approximately 50 % of that in the control arm, after termination of screening. At the same time, in the interval of 9-12 years, the screening group had a similar rate to the control.

More information: A.L.A. Grenabo, et al., "Incidence and mortality of prostate cancer after termination of PSA based screening," Abstract Nr: 2; 28th Annual EAU Congress, 15 to 19 March 2013; Milan, Italy

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