3 The current standard, PSA testing combined with digital rectal examination (DRE), is minimally invasive and easily available, but does not seem to be ideal in reducing mortality, as the results from the ERSPC and PLCO trials suggest. ERSPC The ERSPC study used data from 7 centers in different European countries, with a total of 162,387 men undergoing randomization. Of these, 72,952 men were assigned to the screening

Inhibitors,research,lifescience,medical group and 89,245 men were assigned to the control group. Randomization was 1:1 in all countries except Finland, where the randomization of the whole birth cohort led to a ratio of 1:1.5 for the screening group to the control group. Slightly different methods and follow-up routines were used; PSA cutoff varied from 3 to 4 ng/mL and serum PSA levels necessitating further testing www.selleckchem.com/Caspase.html ranged from 2.5 to 3.9 ng/mL. It is unclear

how much screening was present in the control group throughout the study period. Results between the study centers were shown to be generally similar, and no anomalies were found Inhibitors,research,lifescience,medical in screening or detection rates. Inhibitors,research,lifescience,medical Intervals for the screening group were large-4 years for 87% of patients. With average and median follow-up times of 8.8 and 9.0 years, respectively, there were 214 prostate cancer deaths in the screening group and 326 in the control group. For the screening group, this results in an unadjusted rate ratio for death of 0.80 (95% confidence interval [CI], 0.67–0.95; P = .01), and an adjusted rate ratio of 0.80 (95% CI, 0.65–0.98; P = .04) Inhibitors,research,lifescience,medical (Table 1). In other words, to prevent 1 death from prostate cancer, 1410 (95% CI, 1132–1721) men need to be screened and 48 men treated (Table 2). After adjusting for noncompliance, 1068 need to be treated and the rate ratio after 9 years was 0.73 Inhibitors,research,lifescience,medical (95% CI, 0.56–0.90). It was additionally suggested that the population that benefited

from screening was restricted to men between the ages of 55 to 69 years, and that other age groups did not show a reduction in mortality through screening. Table 1 European Randomized Study of Screening for Prostate Cancer (ERSPC) Results Table 2 European Randomized Study of Screening for Prostate Cancer (ERSPC) Screening Group Methodology and Outcomes PLCO Study In the PLCO trial, 76,693 men at 10 US study centers were included. The 17-DMAG (Alvespimycin) HCl screening group consisted of 38,343 men and the control group consisted of 38,350 men. Randomization was done within blocks of the population stratified according to center, age, and sex. Men in the screening group received annual PSA screenings, whereas those in the control group were not actively screened but sometimes received screening outside of the study, resulting in a contaminated population. The incidence of death per 10,000 person-years was 2.0 (50 deaths) in the screening group and 1.7 (44 deaths) in the control group (rate ratio, 1.13; 95% CI, 0.75–1.70) (Table 3).