%0 Journal Article
%A Luján Galán, Marcos
%A Paez,A
%A Angulo,JC
%A Granados,R
%A Nevado Rodríguez, María Esther
%A Torres García, Antonio José
%A Berenguer,A
%T Prostate cancer incidence and mortality in the spanish section of the european randomized study of screening for prostate cancer (erspc).
%D 2014
%@ 1365-7852
%U https://hdl.handle.net/20.500.14352/116488
%X Background: To present the long-term results of a prostate cancer (PC) screening trial conducted in a Mediterranean setting.Methods: A total of 4276 men aged 45-70 years were randomized to screening arm (PSA test performed) and control arm (no tests). Transrectal ultrasonography-guided sextant prostate biopsy was conducted when PSA > or = 3 ng ml(-1). Date and cause of death were retrieved from death certificates. PC incidence, and disease-specific and overall mortality curves were plotted and comparison between arms was made. Analysis of causes of death was also performed.Results: Median age at randomization was 57.0 years. Median follow-up time was 15.2 years. A total of 241 men were diagnosed with PC, 161 (6.7%) in the screening arm and 80 (4.3%) in the control arm (P<0.01). Eventually, 554 men (13%) died. No difference in all-cause mortality was found between arms (P=0.34). Only 10 men (10/4276, 0.23%) died from PC, no differences between arms (P=0.67). Overall, the main causes of death were malignancy (54.2%), cardiovascular (17.9%) and respiratory (9.2%) diseases. Main cancer causes of death were lung and bronchus cancer (37.2%), colorectum (15.0%) and stomach (9.0%) cancer. PC only accounted for 3.0% of all malignant causes of death (ranked 10th).Conclusions: Our study failed to demonstrate benefits of PC screening in terms of all-cause and PC-specific mortality after a median follow-up of 15 years. The limited sample size and the low long-term PC mortality observed in our setting were probably the most important factors to explain these results.
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