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The idea that screening reduces prostate cancer mortality has largely been a leap of faith. Now, finally, we have a first look at outcomes from two randomized screening trials — and the results are ambiguous.
In the PLCO trial from the U.S., 77,000 men (age range, 55–74) were randomized to screening (annual prostate-specific antigen [PSA] testing for 6 years plus annual digital rectal examination [DRE] for 4 years) or no screening. Men who had PSA levels >4.0 ng/mL or suspicious DREs were advised to seek further evaluation, but subsequent diagnostic and therapeutic interventions were not standardized. Through year 10, there were 92 prostate cancer deaths in the screening group and 82 in the control group, a nonsignificant difference. Overall…
