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US trial shows no early mortality benefit from annual prostate cancer screening
Date:3/18/2009

eview committee that meets every six months, saw a continuing lack of evidence that screening reduces deaths due to prostate cancer as well as the suggestion that screening may cause men to be treated unnecessarily. The PLCO investigators will continue to follow patients for several more years to see whether annual screening eventually reduces prostate cancer deaths.

The trial involved 76,693 men, who were randomly assigned to receive either annual PSA blood tests for six years and digital rectal exams for four years or routine care, which included physical checkups but no mandate for annual prostate cancer screening.

The new report includes data for all participants seven years after they joined the trial and for 67% percent of participants 10 years after they joined the trial.

At seven years, there were 22 percent more prostate cancer diagnoses in the men screened annually (2,820 men in the screening group vs. 2,322 in the routine-care group). This trend has continued in data collected up to 10 years (currently there are 17 percent more prostate cancer diagnoses in the screening group).

Deaths from prostate cancer did not differ significantly between the groups. Seven years after the start of screening, there were 50 deaths from prostate cancer in the screening group and 44 deaths in the routine-care group. Ten years after the start of screening, there were 92 prostate cancer deaths in the screening group and 82 in the routine-care group.

"My recommendation is that, for now, men with a life expectancy of more than seven to 10 years continue to be screened for prostate cancer," says Andriole. "On the other hand, screening is probably not necessary for elderly men and men with significant health issues. These men should have a conversation with their doctors to make an individual decision about whether they want to be screened, because clearly there can be harmful side effects related to treatment, while for these men, the
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Contact: Caroline Arbanas
arbanasc@wustl.edu
314-286-0109
Washington University School of Medicine
Source:Eurekalert

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