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Although screening men for elevations in serum prostate-specific antigen (PSA) levels might lower prostate cancer–specific mortality (NEJM JW Gen Med Mar 18 2009), widespread screening is costly and results in substantial overtreatment. For each prostate cancer death prevented during 11 years of follow-up in a recent European study, about 1000 men were screened, and >30 prostate cancers were diagnosed (NEJM JW Gen Med Mar 14 2012). Might a focused approach be more effective? In this study, investigators in Sweden assessed how baseline serum PSA levels at age 60 modified the effects of screening.
The screened group consisted of 1800 men who participated in the screening arm of the Gothenburg randomized prostate cancer screening trial; the uns…