Related Experiment Video
Updated: Jun 6, 2026
06:28
E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
What can be concluded from the ERSPC and PLCO trial data?
Urs E Studer1, Laurence Collette
1Department of Urology, University Hospital Bern, Bern, Switzerland. urs.studer@insel.ch
Urologic Oncology
|November 11, 2010
Summary
Conflicting prostate cancer screening trial results highlight overdetection issues. More specific PSA screening tools are needed to identify aggressive cancers and avoid overtreatment of indolent cases.
Area of Science:
- Urology
- Oncology
- Preventive Medicine
Background:
- Interim analyses of the European Randomized study of Prostate Cancer (erSPC) and Prostate Cancer Intervention versus Observation (PlCO) trials present conflicting conclusions.
- The value of prostate-specific antigen (PSA) screening for prostate cancer remains debated due to these divergent findings.
Purpose of the Study:
- To review and analyze the erSPC and PlCO trial publications.
- To explore potential reasons for the contradictory conclusions between the two studies.
Main Methods:
- Review of published interim analyses from the erSPC and PlCO prostate cancer screening trials.
- Comparative analysis of study methodologies and results to identify discrepancies.
Main Results:
- The erSPC and PlCO trials yielded conflicting results regarding PSA screening efficacy.
- Potential factors contributing to the PlCO trial's negative findings include patient prescreening, biopsy failures, control arm contamination, and short follow-up.
- Both studies identified significant overdetection and overtreatment concerns, with the erSPC study showing a low positive predictive value for PSA-triggered biopsies (24%) and detection of many low-risk cancers.
Conclusions:
- Current PSA screening methods for prostate cancer face challenges with overdetection and overtreatment.
- The development of more sensitive and specific screening tools is crucial to differentiate aggressive from indolent prostate cancers.
- Physicians and patients must be aware that many detected prostate cancers are indolent and may not impact mortality. Early detection benefits are maximized when treatment is reserved for patients with aggressive disease.
Related Concept Videos
01:16Clinical Trials
Clinical trials are prospective experimental studies conducted on humans to determine the safety and efficacy of treatments, drugs, diet methods, and medical devices. Using statistics in clinical trials enables researchers to derive reasonable and accurate conclusions from the collected data, allowing them to make wise decisions in uncertain situations. In medical research, statistical methods are crucial for preventing errors and bias.
There are four phases in a clinical trial. A phase one...
There are four phases in a clinical trial. A phase one...
01:11Clinical Trials: Overview
Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...