Editing Prostate Cancer: Screening (section)

=== <span style="color:#ff00ff">European Randomized study of Screening for Prostate Cancer (ERSPC)</span> ===
* '''<span style="color:#ff0000">Population: 162,243 males aged 55-69 (almost twice the size of PLCO) from 8 European countries;</span>''' collection of trials conducted, some differences between individual trials
* '''<span style="color:#ff0000">Randomized to screening every 4 years</span> (PSA in most centres; some centres offered DRE) <span style="color:#ff0000">vs. standard care</span>'''
* Primary outcome: prostate cancer-specific mortality
* '''<span style="color:#ff0000">Results</span>''' (2019 results):
** '''PC mortality: RR 0.80''' (0.72–0.89)
*** '''Number needed to invite (NNI) to screening to prevent one prostate cancer death: 570'''
*** '''Number needed to diagnose (NND) to prevent one prostate cancer death: 18'''
*** Estimated that annual screening of men in the ERSPC aged 55 to 69 years would result in a 28% reduction in prostate cancer deaths (37% in those actually screened). The estimated number needed to screen to prevent one prostate cancer death was 98, and the number of cancers needed to be detected was 5
** Incidence: RR 1.41 (1.36–1.45)
* '''Lower rate (≈20-25%) of contamination'''
* [https://pubmed.ncbi.nlm.nih.gov/19297566/ Schröder, Fritz H., et al.] "Screening and prostate-cancer mortality in a randomized European study." New England Journal of Medicine 360.13 (2009): 1320-1328.
* [https://pubmed.ncbi.nlm.nih.gov/30824296/ Hugosson, Jonas, et al.] "A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer." European urology 76.1 (2019): 43-51.
*'''Subgoup analysis'''
**'''Population: 7,052 males aged 70-74 at their last screening visit after a maximum of 3 consecutive screening rounds and who had completed screening without a PCa diagnosis.'''
**Primary outcome: cumulative incidence of prostate cancer-specific mortality by the age of 85
**'''Results'''
***324 males diagnosed with prostate cancer, after a median time period between last screening visit and diagnosis of 7 years
***107 males found to have metastasis
***81 males died of disease
***'''Cumulative incidence of prostate cancer-specific survival by the age of 85 was 0.54%'''
****Cumulative incidence higher in patients with higher PSA or no previous biopsy
** [https://pubmed.ncbi.nlm.nih.gov/37919190/ de Vos, Ivo I., et al. "Prostate Cancer Mortality Among Elderly Men After Discontinuing Organised Screening: Long-term Results from the European Randomized Study of Screening for Prostate Cancer Rotterdam." ''European Urology'' 85.1 (2024): 74-81.]