Effect of a low-intensity PSA-based screening intervention on prostate cancer mortality: the CAP randomized clinical trial


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Richard Martin1
1University of Bristol


Background: Prostate-cancer screening remains controversial because of concerns that potential mortality or quality of life benefits are outweighed by harms from over-detection and subsequent over-treatment. Aims: We investigated the effect of an invitation to a single PSA-screen for prostate cancer on prostate cancer detection and median 10-year prostate cancer mortality. Findings: In this UK-based cluster randomized clinical trial comparing 189,386 men aged 50-69 receiving a single PSA-screen and 219,439 controls undergoing standard (unscreened) practice, the proportion of men diagnosed with prostate cancer was higher in the intervention (4.3%) group than control (3.6%) group, but there was no significant difference in prostate cancer mortality (intervention, 0.29% vs. control, 0.29%) after a median follow-up of 10-years. Conclusion: The CAP single PSA-screen intervention detected more prostate cancer cases, but after a median of 10-years’ follow-up has, thus far, had no significant effect on prostate cancer mortality.