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. 1999 Mar;79(7-8):1210–1214. doi: 10.1038/sj.bjc.6690194

European randomized study of prostate cancer screening: first-year results of the Finnish trial

L Määttänen 1, A Auvinen 1,2, U-H Stenman 3, S Rannikko 4, T Tammela 5, J Aro 6, H Juusela 6, M Hakama 1,8
PMCID: PMC2362232  PMID: 10098761

Abstract

Approximately 20 000 men 55–67 years of age from two areas in Finland were identified from the Population Registry and randomized either to the screening arm (1/3) or the control arm (2/3) of a prostate cancer screening trial. In the first round, the participation rate in the screening arm was 69%. Of the 5053 screened participants, 428 (8.5%) had a serum prostate-specific antigen (PSA) concentration of 4.0 ng/ml or higher, and diagnostic examinations were performed on 399 of them. A total of 106 cancers were detected among them corresponding to a positive predictive value of 27%, which is comparable with mammography screening for breast cancer. The prostate cancer detection rate based on a serum PSA concentration of 4.0 ng ml−1 or higher was 2.1%. Approximately nine out of ten screen-detected prostate cancers were localized (85% clinical stage T1–T2) and well or moderately differentiated (42% World Health Organization (WHO) grade I and 50% grade II), which suggests a higher proportion of curable cancers compared with cases detected by other means. © 1999 Cancer Research Campaign

Keywords: screening, prostate neoplasms, randomized controlled trials, prostate-specific antigen

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Selected References

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  1. Catalona W. J., Smith D. S., Ratliff T. L., Dodds K. M., Coplen D. E., Yuan J. J., Petros J. A., Andriole G. L. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med. 1991 Apr 25;324(17):1156–1161. doi: 10.1056/NEJM199104253241702. [DOI] [PubMed] [Google Scholar]
  2. Denis L. J., Murphy G. P., Schröder F. H. Report of the consensus workshop on screening and global strategy for prostate cancer. Cancer. 1995 Mar 1;75(5):1187–1207. doi: 10.1002/1097-0142(19950301)75:5<1187::aid-cncr2820750521>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  3. Dugan J. A., Bostwick D. G., Myers R. P., Qian J., Bergstralh E. J., Oesterling J. E. The definition and preoperative prediction of clinically insignificant prostate cancer. JAMA. 1996 Jan 24;275(4):288–294. [PubMed] [Google Scholar]
  4. Hakama M., Elovainio L., Kajantie R., Louhivuori K. Breast cancer screening as public health policy in Finland. Br J Cancer. 1991 Nov;64(5):962–964. doi: 10.1038/bjc.1991.436. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Kerlikowske K., Grady D., Barclay J., Sickles E. A., Eaton A., Ernster V. Positive predictive value of screening mammography by age and family history of breast cancer. JAMA. 1993 Nov 24;270(20):2444–2450. [PubMed] [Google Scholar]
  6. Labrie F., Candas B., Cusan L., Gomez J. L., Diamond P., Suburu R., Lemay M. Diagnosis of advanced or noncurable prostate cancer can be practically eliminated by prostate-specific antigen. Urology. 1996 Feb;47(2):212–217. doi: 10.1016/S0090-4295(99)80419-1. [DOI] [PubMed] [Google Scholar]
  7. Lilja H., Christensson A., Dahlén U., Matikainen M. T., Nilsson O., Pettersson K., Lövgren T. Prostate-specific antigen in serum occurs predominantly in complex with alpha 1-antichymotrypsin. Clin Chem. 1991 Sep;37(9):1618–1625. [PubMed] [Google Scholar]
  8. Mettlin C., Murphy G. P., Babaian R. J., Chesley A., Kane R. A., Littrup P. J., Mostofi F. K., Ray P. S., Shanberg A. M., Toi A. The results of a five-year early prostate cancer detection intervention. Investigators of the American Cancer Society National Prostate Cancer Detection Project. Cancer. 1996 Jan 1;77(1):150–159. doi: 10.1002/(SICI)1097-0142(19960101)77:1<150::AID-CNCR25>3.0.CO;2-3. [DOI] [PubMed] [Google Scholar]
  9. Peer P. G., van Dijck J. A., Hendriks J. H., Holland R., Verbeek A. L. Age-dependent growth rate of primary breast cancer. Cancer. 1993 Jun 1;71(11):3547–3551. doi: 10.1002/1097-0142(19930601)71:11<3547::aid-cncr2820711114>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  10. Potosky A. L., Kessler L., Gridley G., Brown C. C., Horm J. W. Rise in prostatic cancer incidence associated with increased use of transurethral resection. J Natl Cancer Inst. 1990 Oct 17;82(20):1624–1628. doi: 10.1093/jnci/82.20.1624. [DOI] [PubMed] [Google Scholar]
  11. Schmid H. P., McNeal J. E., Stamey T. A. Observations on the doubling time of prostate cancer. The use of serial prostate-specific antigen in patients with untreated disease as a measure of increasing cancer volume. Cancer. 1993 Mar 15;71(6):2031–2040. doi: 10.1002/1097-0142(19930315)71:6<2031::aid-cncr2820710618>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  12. Schröder F. H., Boyle P. Screening for prostate cancer--necessity or nonsense? Eur J Cancer. 1993;29A(5):656–661. doi: 10.1016/s0959-8049(05)80339-9. [DOI] [PubMed] [Google Scholar]
  13. Shröder F. H., Damhuis R. A., Kirkels W. J., De Koning H. J., Kranse R., Nus H. G., Blijenberg B. G. European randomized study of screening for prostate cancer--the Rotterdam pilot studies. Int J Cancer. 1996 Jan 17;65(2):145–151. doi: 10.1002/(SICI)1097-0215(19960117)65:2<145::AID-IJC4>3.0.CO;2-Z. [DOI] [PubMed] [Google Scholar]
  14. Smith D. S., Catalona W. J., Herschman J. D. Longitudinal screening for prostate cancer with prostate-specific antigen. JAMA. 1996 Oct 23;276(16):1309–1315. [PubMed] [Google Scholar]
  15. Stenman U. H., Hakama M., Knekt P., Aromaa A., Teppo L., Leinonen J. Serum concentrations of prostate specific antigen and its complex with alpha 1-antichymotrypsin before diagnosis of prostate cancer. Lancet. 1994 Dec 10;344(8937):1594–1598. doi: 10.1016/s0140-6736(94)90405-7. [DOI] [PubMed] [Google Scholar]
  16. Stenman U. H., Leinonen J., Alfthan H., Rannikko S., Tuhkanen K., Alfthan O. A complex between prostate-specific antigen and alpha 1-antichymotrypsin is the major form of prostate-specific antigen in serum of patients with prostatic cancer: assay of the complex improves clinical sensitivity for cancer. Cancer Res. 1991 Jan 1;51(1):222–226. [PubMed] [Google Scholar]
  17. Teppo L., Pukkala E., Lehtonen M. Data quality and quality control of a population-based cancer registry. Experience in Finland. Acta Oncol. 1994;33(4):365–369. doi: 10.3109/02841869409098430. [DOI] [PubMed] [Google Scholar]

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