No Mortality Benefit in Third Major Trial of PSA Screening

The conflicting results of the U.S. and European trials of prostate-specific antigen (PSA) screening for prostate cancer have led to considerable controversy and ambiguous recommendations about PSA screening. Now, in a third major trial (the largest to date), U.K. investigators randomized 573 primary care practices to offer eligible men (age range, 50–69) either a single PSA screening or usual care (PSA information sheet provided only on patient request). Each group included approximately 200,000 men, and about a third of the intervention group underwent PSA testing. The 11% of tested men who had PSA levels >3 ng/mL underwent biopsy and then, if eligible, were randomized to radical prostatectomy, external beam radiation, or active surveilla…