Match!

Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials

Published on Oct 3, 2017in Annals of Internal Medicine19.32
· DOI :10.7326/M16-2586
Alexander Tsodikov39
Estimated H-index: 39
,
Roman Gulati29
Estimated H-index: 29
(Fred Hutchinson Cancer Research Center)
+ 19 AuthorsRuth Etzioni50
Estimated H-index: 50
(Fred Hutchinson Cancer Research Center)
View in Source
Abstract
Background: The ERSPC (European Randomized Study of Screening for Prostate Cancer) found that screening reduced prostate cancer mortality, but the PLCO (Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial) found no reduction. Objective: To evaluate whether effects of screening on prostate cancer mortality relative to no screening differed between the ERSPC and PLCO. Design: Cox regression of prostate cancer death in each trial group, adjusted for age and trial. Extended analyses accounted for increased incidence due to screening and diagnostic work-up in each group via mean lead times (MLTs), which were estimated empirically and using analytic or microsimulation models. Setting: Randomized controlled trials in Europe and the United States. Participants: Men aged 55 to 69 (ERSPC) or 55 to 74 (PLCO) years at randomization. Intervention: Prostate cancer screening. Measurements: Prostate cancer incidence and survival from randomization; prostate cancer incidence in the United States before screening began. Results: Estimated MLTs were similar in the ERSPC and PLCO intervention groups but were longer in the PLCO control group than the ERSPC control group. Extended analyses found no evidence that effects of screening differed between trials (P = 0.37 to 0.47 [range across MLT estimation approaches]) but strong evidence that benefit increased with MLT (P = 0.0027 to 0.0032). Screening was estimated to confer a 7% to 9% reduction in the risk for prostate cancer death per year of MLT. This translated into estimates of 25% to 31% and 27% to 32% lower risk for prostate cancer death with screening as performed in the ERSPC and PLCO intervention groups, respectively, compared with no screening. Limitation: The MLT is a simple metric of screening and diagnostic work-up. Conclusion: After differences in implementation and settings are accounted for, the ERSPC and PLCO provide compatible evidence that screening reduces prostate cancer mortality. Primary Funding Source: National Cancer Institute.
Figures & Tables
  • References (19)
  • Citations (54)
References19
Newest
#1Peter Sasieni (QMUL: Queen Mary University of London)H-Index: 50
#2Adam R. Brentnall (QMUL: Queen Mary University of London)H-Index: 18
5 CitationsSource
#1Paul F. PinskyH-Index: 53
#2Philip C. ProrokH-Index: 39
Last.Gerald L. AndrioleH-Index: 73
view all 9 authors...
57 CitationsSource
#1Ahmedin Jemal (ACS: American Cancer Society)H-Index: 106
#2Jiemin Ma (ACS: American Cancer Society)H-Index: 22
Last.Elizabeth Ward (ACS: American Cancer Society)H-Index: 72
view all 6 authors...
34 CitationsSource
#1Ahmedin Jemal (ACS: American Cancer Society)H-Index: 106
#2Stacey A. Fedewa (ACS: American Cancer Society)H-Index: 34
Last.Elizabeth Ward (ACS: American Cancer Society)H-Index: 72
view all 7 authors...
218 CitationsSource
#1Fritz H. Schröder (Erasmus University Medical Center)H-Index: 89
#2Jonas Hugosson (University of Gothenburg)H-Index: 50
Last.Anssi Auvinen (RMIT: RMIT University)H-Index: 73
view all 29 authors...
656 CitationsSource
#1Hajime Uno (Harvard University)H-Index: 36
#2Brian Claggett (Harvard University)H-Index: 40
Last.Lee-Jen Wei (Stanford University)H-Index: 44
view all 16 authors...
161 CitationsSource
#1Joy Melnikow (UC Davis: University of California, Davis)H-Index: 26
#2Michael L. LeFevre (MU: University of Missouri)H-Index: 38
Last.Virginia A. Moyer (BCM: Baylor College of Medicine)H-Index: 48
view all 4 authors...
17 CitationsSource
#1Virginia A. Moyer (University of Texas Health Science Center at Houston)H-Index: 22
1,593 CitationsSource
#1Roman Gulati (Fred Hutchinson Cancer Research Center)H-Index: 29
#2Alexander Tsodikov (UM: University of Michigan)H-Index: 39
Last.Ruth Etzioni (Fred Hutchinson Cancer Research Center)H-Index: 50
view all 8 authors...
53 CitationsSource
901 CitationsSource
Cited By54
Newest
#1Reith Sarkar (UCSD: University of California, San Diego)H-Index: 3
#2Brent S. Rose (UCSD: University of California, San Diego)H-Index: 14
Source
#1Philip Zeuschner (Saarland University)H-Index: 2
#2Johannes Linxweiler (Saarland University)H-Index: 7
Last.Kerstin Junker (Saarland University)H-Index: 39
view all 3 authors...
Source
#1Matthias SaarH-Index: 12
Last.M. StöckleH-Index: 11
view all 6 authors...
Source
#1Ji Lyu (University of Electronic Science and Technology of China)
#2Lin Zhao ('SMMU': Second Military Medical University)H-Index: 3
Last.Yinghao Sun ('SMMU': Second Military Medical University)H-Index: 32
view all 12 authors...
Source
#1Carol DeSantis (ACS: American Cancer Society)H-Index: 25
#2Kimberly D. Miller (ACS: American Cancer Society)H-Index: 18
Last.Rebecca L. Siegel (ACS: American Cancer Society)H-Index: 47
view all 9 authors...
Source
#1Giorgio Gandaglia (UniSR: Vita-Salute San Raffaele University)H-Index: 31
#2Peter Albers (HHU: University of Düsseldorf)H-Index: 43
Last.Hein Van Poppel (Katholieke Universiteit Leuven)H-Index: 73
view all 12 authors...
5 CitationsSource
2 CitationsSource
#1Jonas HugossonH-Index: 50
#2Monique J. Roobol (EUR: Erasmus University Rotterdam)H-Index: 61
Last.Anssi Auvinen (UTA: University of Tampere)H-Index: 73
view all 31 authors...
12 CitationsSource
#1Reith Sarkar (UCSD: University of California, San Diego)H-Index: 3
#2J. Kellog Parsons (UCSD: University of California, San Diego)H-Index: 1
Last.Brent S. Rose (UCSD: University of California, San Diego)H-Index: 14
view all 14 authors...
8 CitationsSource
#1Robert A. Smith (ACS: American Cancer Society)H-Index: 81
#2Kimberly S. Andrews (ACS: American Cancer Society)H-Index: 18
Last.Richard C. Wender (ACS: American Cancer Society)H-Index: 31
view all 7 authors...
7 CitationsSource