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Prostate Cancer Screening: What We Have Learned from the PLCO and ERSPC Trials

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Abstract

Two large randomized trials on prostate cancer screening have recently reported their 10-year results with somewhat differing conclusions. The Prostate, Lung, Colorectal, and Ovarian Cancer Screening (PLCO) study found a slightly higher risk of a prostate cancer diagnosis in the screening cohort, but no cancer-specific survival advantage was seen for this group. However, the study had widespread screening contamination in the control arm that significantly weakens the study’s ability to reach a valid conclusion about the benefits of screening. The European Randomized Study of Screening in Prostate Cancer (ERSPC) was less affected by screening contamination of the control arm, and a cancer-specific survival benefit for the screening arm was seen by 7–8 years (RR, 0.70–0.80). Based on these studies, it is reasonable to conclude that there is a survival benefit for screening, but it may not extend to older men (>75 years) who have undergone prior screening.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. American Cancer Society: Cancer Facts and Figures 2009. Atlanta, GA: 2009. Available at http://www.cancer.org/downloads/STT/500809web.pdf.

  2. • Bill-Axelson A, Holmberg L, Ruutu M, et al.: Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med 2005, 352:1977–1984. This report comes from the first randomized study to demonstrate a survival benefit for radical prostatectomy over conservative management.

    Article  PubMed  CAS  Google Scholar 

  3. United States Preventive Services Task Force: Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2008, 149:185–191.

    Google Scholar 

  4. •• Andriole GL, Crawford ED, Grubb RL, et al.: Mortality results from a randomized prostate-cancer screening trial. N Engl J Med 2009, 360:1310–1319. This is the interim report from the PLCO trial, which includes a good discussion of some of the drawbacks of this study.

    Article  PubMed  CAS  Google Scholar 

  5. •• Schroder FH, Hugosson J, Roobol MJ, et al.: Screening and prostate-cancer mortality in a randomized European study. N Engl J Med 2009, 360:1320–1328. This is the ERSPC report, which shows a cancer-specific survival benefit for prostate cancer screening.

    Article  PubMed  Google Scholar 

  6. Thompson IM, Pauler DK, Goodman PJ, et al.: Prevalence of prostate cancer among men with a prostate-specific antigen level ≤4.0 ng per milliliter. N Engl J Med 2004, 350:2239–2246.

    Article  PubMed  CAS  Google Scholar 

  7. Carter HB, Ferrucci L, Kettermann A, et al.: Detection of life-threatening prostate cancer with prostate-specific antigen velocity during a window of curability. J Natl Cancer Inst 2006, 98:1521–1527.

    Article  PubMed  Google Scholar 

  8. Moul JW, Sun L, Hotaling JM, et al.: Age adjusted prostate specific antigen and prostate cancer specific antigen velocity cut points in prostate cancer screening. J Urol 2007, 177:499–503.

    Article  PubMed  CAS  Google Scholar 

  9. Loeb S, Roehl KA, Nadler RB, et al.: Prostate specific antigen velocity in men with total prostate cancer specific antigen less than 4 ng/ml. J Urol 2007, 178:2348–2352.

    Article  PubMed  CAS  Google Scholar 

  10. • Lu-Yao GL, Albertsen PC, Moore DF, et al.: Outcomes of localized prostate cancer following conservative management. JAMA 2009, 302:1202–1209. This report, based on the SEER database, demonstrates the prolonged natural history of prostate cancer and gives us a better idea of the timeframe that we should keep in mind when treating and studying prostate cancer.

    Article  PubMed  CAS  Google Scholar 

  11. Roobol MJ, Kerkhof M, Schrode FH, et al.: Prostate cancer mortality reduction by prostate-specific antigen-based screening adjusted for nonattendance and contamination in the European Randomized Study of Screening for Prostate Cancer (ERSPC). Eur Urol 2009, 56:584–591.

    Article  PubMed  Google Scholar 

  12. Klotz L, Zhang L, Lam A, et al.: Clinical results of long-term follow-up of a large, active surveillance cohort with localized prostate cancer. J Clin Oncol 2009, 28:126–131.

    Article  PubMed  Google Scholar 

  13. Lu-Yao GL, Albertsen PC, Moore DF, et al.: Survival following primary androgen deprivation therapy among men with localized prostate cancer. JAMA 2008, 300:173–181.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Division of Urology, Oregon Health and Sciences University, 3303 SW Bond Avenue, Mail Code CH10U, Portland, OR, 97239, USA

    Jeffrey La Rochelle & Christopher L. Amling

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  1. Jeffrey La Rochelle
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  2. Christopher L. Amling
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Correspondence to Jeffrey La Rochelle.

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La Rochelle, J., Amling, C.L. Prostate Cancer Screening: What We Have Learned from the PLCO and ERSPC Trials. Curr Urol Rep 11, 198–201 (2010). https://doi.org/10.1007/s11934-010-0109-5

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  • DOI: https://doi.org/10.1007/s11934-010-0109-5

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