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Randomised controlled trial
Prostate cancer screening has no effect on prostate cancer specific mortality over 20 years of follow-up of Swedish men
  1. Pim J van Leeuwen
  1. Erasmus Medical Centre, University Medical Centre, Rotterdam, The Netherlands
  1. Correspondence to Pim J van Leeuwen
    Erasmus MC, University Medical Centre, Room NH 227, PO Box 2040, 3000 CA Rotterdam, The Netherlands; p.vanleeuwen{at}erasmusmc.nl

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Context

Screening for prostate cancer (PC) is one of the most controversial subjects in uro-oncology. PC is the second most common male cancer worldwide. Although PC is not rare, it has a variable natural history, ranging from indolent to strikingly aggressive with a long preclinical phase. Although we await a breakthrough in the treatment of advanced disease, earlier diagnosis of clinically significant disease could provide an opportunity to ‘stem the tide’.

Methods

The Norrkoping PC screening trial reported on mortality 20 years after the start of the study. The study provided data on 9026 men from the Swedish city of Norrkoping who were between the ages of 50 and 69 years in 1987. Of these men, 1494 were randomly selected for screening; they were initially screened for PC with a digital rectal examination (DRE) only in 1987 and again in 1990. In 1993, they also received a prostate-specific antigen (PSA) test as well …

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