Prostate‑Specific Antigen Screening and 15‑Year Prostate Cancer Mortality

Rákkutatás · Prostate cancer

A single invitation for PSA screening reduces prostate cancer mortality at a median follow‑up of 15 years, but the absolute benefit is small.

In this secondary analysis of the CAP randomized clinical trial, 415,957 men aged 50‑69 were randomized to a single invitation for PSA screening or to no invitation. At a median 15‑year follow‑up the prostate‑cancer‑specific mortality was 0.69% (1199 deaths) in the screened group versus 0.78% (1451 deaths) in the control group, yielding a rate ratio of 0.92 (95% CI 0.85‑0.99; P = 0.03). Screening increased detection of low‑grade and localized disease but did not affect intermediate or high‑grade disease rates. The absolute reduction in deaths was small, and biopsy or treatment‑related deaths were rare (0.7% of deaths in the screened group).

The findings suggest that a single PSA invitation modestly reduces prostate‑cancer mortality over 15 years, providing evidence for the potential benefit of PSA screening strategies while highlighting the minimal absolute benefit and low but present procedural harms.

Bizonyítékszint: Irányelv / elfogadott gyakorlat. Magas szintű klinikai elfogadottság.

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