PD46-06 PSA BASED SCREENING FOR PROSTATE CANCER: STARTING TOO LATE AND NON-COMPLIANCE, LIMITING THE NUMBER OF SCREENING VISITS, NEGATIVELY AFFECT PC MORTALITY REDUCTION.

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening V1 Apr 2015PD46-06 PSA BASED SCREENING FOR PROSTATE CANCER: STARTING TOO LATE AND NON-COMPLIANCE, LIMITING THE NUMBER OF SCREENING VISITS, NEGATIVELY AFFECT PC MORTALITY REDUCTION. Monique Roobol and ERSPC study group Rotterdam Monique RoobolMonique Roobol More articles by this author and ERSPC study group RotterdamERSPC study group Rotterdam More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2737AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The published 3rd update of ERSPC (European Randomized study of Screening for Prostate Cancer) showed an increase in absolute PC mortality reduction (AR: from 1.07 to 1.28 per 1000 men) but no increase in the relative PC mortality reduction (RR) in favor of screening (stable RR of 20%). I.e. more events occur over time but at a similar relative increase. ERSPC Rotterdam (ERSPC-R) continues screening (scr) up to 75 years and has most biopsy referrals. METHODS ERSPC_R randomized 42,376 men aged 55-74 yr, to either scr (S, N=21,210) or control arm (N=21,166) in the period 1993-1999. Scr interval is 4 yr with PSA >= 3.0 ng/ml triggering biopsy. We compare the published 2010 data (follow-up (FU) 12.8 yr; the 2010_data) with the 2012 data (FU of 14.5 yr; the 2012_data, 97% complete) focusing at newly emerged PC deaths; specifically in interval PC ( I-PC detected in men in S-arm outside the scr protocol) and S-detected PC cases. RESULTS The increase in PC deaths in S-arm and C-arm is comparable, 18.4% (2010_data) and 17.5% (2012_data), the RR of PC mortality reduction remained stable: 20% and 20.6% res. Similar data in age group 55-69 yr show a 19.3% and 16.1% increase in PC deaths in S- and C-arm res. and RR decreasing from 31.6% to 28.9%. AR changed from 2.6 to 2.8 PC deaths per 1000 men. The table (PC deaths) shows that 40% of PC deaths in the S-arm occur in I-PC. New PC deaths in the S-arm mainly occurred in 2nd round S-detected PC and I-PC emerging in the 3rd and 4th interval. Fatal S-detected PC at 2nd round consisted for 50% of men > 60 yr at 1st screen and for 33% of men with a PSA between 3 and 4 and no biopsy at 1st screen. 3rd and 4th period I-PC deaths (N=39 in total age group) mainly emerged in men > 70 yr at randomization, hence screened only once (N=14) and in men that did not attend next screening ( i.e often screened once) mostly due to previous negative biopsies (N=14). 11 I-PC were in men fully screened. CONCLUSIONS ERSPC-R 2012_data confirm the stable RR. The increase in PC deaths in the S-arm is mainly due to starting too late and non-compliance with the S-algorithm (limiting the number of screens). A more tailored S-algorithm potentially reducing non-compliance and starting at younger age may increase the effect of PC screening on PC specific mortality. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e958 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Monique Roobol More articles by this author ERSPC study group Rotterdam More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...