Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial
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View abstract on PubMed
Summary
This summary is machine-generated.A single prostate-specific antigen (PSA) screening did not reduce prostate cancer mortality in a large UK trial. However, it increased the detection of low-risk cancers, suggesting it may not be suitable for population-wide screening.
Area Of Science
- Urology
- Oncology
- Public Health
Background
- Prostate cancer screening is debated due to potential benefits versus harms like overdetection and overtreatment.
- The Prostate Cancer Screening Trial (CAP) aimed to clarify the impact of prostate-specific antigen (PSA) testing.
Purpose Of The Study
- To evaluate the effect of a single PSA screening intervention on prostate cancer-specific mortality.
- To assess secondary outcomes including cancer stage, grade, and all-cause mortality.
Main Methods
- A cluster randomized trial involving 419,582 men aged 50-69 in the UK.
- Intervention group received a single PSA test invitation; control group received standard care.
- Median follow-up was 10 years, with prostate cancer-specific mortality as the primary outcome.
Main Results
- No significant difference in prostate cancer-specific mortality between the intervention and control groups (0.30 vs 0.31 per 1000 person-years).
- Increased diagnosis of prostate cancer (4.3% vs 3.6%) and detection of low-grade (Gleason 6 or lower) tumors in the intervention group.
- No significant difference in all-cause mortality between groups.
Conclusions
- A single PSA screening intervention did not reduce prostate cancer mortality.
- The intervention led to increased detection of low-risk prostate cancer, raising concerns about overdiagnosis.
- Findings do not support the use of single PSA testing for population-based prostate cancer screening.
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