Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality
A single low‑intensity PSA screening invitation did not reduce prostate‑cancer mortality over a median 10‑year follow‑up, although it increased detection of low‑risk disease.
The CAP trial was a cluster randomized controlled trial enrolling men aged 50‑69 years across 573 primary care practices in the UK. Men were randomized to receive either an invitation for a single PSA test or routine care. Over a median follow‑up of ten years, prostate‑cancer mortality was 0.30 per 1000 person‑years in the screened group compared with 0.31 in the unscreened group (rate ratio 0.96, 95% CI 0.85‑1.08). The screening arm had a higher rate of prostate‑cancer diagnoses (4.3% vs 3.6%) and more low‑grade tumors, but no mortality benefit was seen.
The results suggest that single, low‑intensity PSA screening increases detection of low‑risk prostate cancer without reducing mortality, underscoring the potential harms of overdiagnosis and supporting more selective screening strategies.
Bizonyítékszint: Klinikai vizsgálat. Formális klinikai vizsgálati eredmény.
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