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Published on: November 2, 2013
Screening for prostate cancer: have we resolved the controversy?
Xiaoye Zhu1, Monique J Roobol, Fritz H Schröder
1Department of Urology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. y.zhu@erasmusmc.nl
Current Opinion in Supportive and Palliative Care
|May 22, 2010
Summary
Prostate cancer screening shows mortality reduction in the ERSPC study but not in the PLCO trial. Further research on quality of life and cost-efficiency is needed before population-based prostate cancer screening implementation.
Area of Science:
- Urology
- Oncology
- Preventive Medicine
Background:
- Prostate cancer (PCa) screening remains controversial.
- The European Randomized Study of Screening for Prostate Cancer (ERSPC) and the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) provide key data.
Purpose of the Study:
- To review interim results from ERSPC and PLCO studies.
- To discuss implications for prostate cancer screening strategies.
Main Methods:
- Systematic review and critical appraisal of ERSPC and PLCO trial data.
- Analysis of prostate-specific antigen (PSA)-based screening outcomes.
Main Results:
- ERSPC reported a 20-31% reduction in PCa-specific mortality with screening.
- PLCO trial showed no significant mortality reduction.
- ERSPC results are considered more reliable due to study design.
Conclusions:
- Insufficient evidence currently exists for population-based PCa screening programs.
- Urgent completion of quality of life and cost-efficiency studies is required.
- Improvements in screening tests, protocols, and risk assessment are necessary to minimize overdiagnosis and overtreatment while maintaining mortality benefits.
