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Methods We identified 182,000 men between the ages of 50 and 74 years through registries in seven European countries for inclusion in our study. The men were randomly assigned to a group that was offered PSA screening at an average of once every 4 years or to a control group that did not receive such screening. The predefined core age group for this study included 162,243 men between the ages of 55 and 69 years. The primary outcome was the rate of death from prostate cancer. Mortality follow-up was identical for the two study groups and ended on December 31, 2006. Results In the screening group, 82% of men accepted at least one offer of screening.

During a median follow-up of 9 years, the cumulative incidence of prostate cancer was 8.2% in the screening group and 4.8% in the control group. The rate ratio for death from prostate cancer in the screening group, as compared with the control group, was 0.80 (95% confidence interval [CI], 0.65 to 0.98; adjusted P=0.04). The absolute risk difference was 0.71 death per 1000 men.

This means that 1410 men would need to be screened and 48 additional cases of prostate cancer would need to be treated to prevent one death from prostate cancer. The analysis of men who were actually screened during the first round (excluding subjects with noncompliance) provided a rate ratio for death from prostate cancer of 0.73 (95% CI, 0.56 to 0. Passengers By Jon Spaihts Pdf Writer. 90). Figure 2 Cumulative Risk of Death from Prostate Cancer. As of December 31, 2006, with an average follow-up time of 8.8 years, there were 214 prostate-cancer deaths in the screening group and 326 in the control group. Deaths that were associated with interventions were categorized as being due to prostate cancer.

The adjusted rate ratio for death from prostate cancer in the screening group was 0.80 (95% CI, 0.65 to 0.98; P=0.04). The Nelsen–Aalen method was used for the calculation of cumulative hazard. Measurement of serum prostate-specific antigen (PSA), a biomarker for prostate cancer, is useful for the detection of early prostate cancer. Nevertheless, the effect of PSA-based screening on prostate-cancer mortality remains unclear. The European Randomized Study of Screening for Prostate Cancer (ERSPC) was initiated in the early 1990s to determine whether a reduction of 25% in prostate-cancer mortality could be achieved by PSA-based screening.