Research Article

Screening decreases prostate cancer mortality: 11-year follow-up of the 1988 Quebec prospective randomized controlled trial

  1. Fernand Labrie*,
  2. Bernard Candas,
  3. Lionel Cusan,
  4. Jose Luis Gomez,
  5. Alain Bélanger,
  6. G. Brousseau,
  7. Eric Chevrette,
  8. Jacques Lévesque

Article first published online: 5 JAN 2004

DOI: 10.1002/pros.20017

Issue

The Prostate

The Prostate

Volume 59, Issue 3, pages 311–318, 15 May 2004

Additional Information

How to Cite

Labrie, F., Candas, B., Cusan, L., Gomez, J. L., Bélanger, A., Brousseau, G., Chevrette, E. and Lévesque, J. (2004), Screening decreases prostate cancer mortality: 11-year follow-up of the 1988 Quebec prospective randomized controlled trial. The Prostate, 59: 311–318. doi: 10.1002/pros.20017

Author Information

  1. Oncology and Molecular Endocrinology Research Center and Departments of Medicine and Radiology, Laval University Medical Center (CHUL), and Laval University, Quebec, Canada

*Oncology and Molecular Endocrinology Research Center and Departments of Medicine and Radiology, Laval University Medical Center (CHUL), and Laval University, Quebec, G1V 4G2, Canada.

Publication History

  1. Issue published online: 19 MAR 2004
  2. Article first published online: 5 JAN 2004
  3. Manuscript Accepted: 21 OCT 2003
  4. Manuscript Received: 19 MAY 2003

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Keywords:

  • prostate cancer;
  • screening;
  • PSA;
  • hormonal therapy

Abstract

PURPOSE

This clinical trial is aimed at evaluating the impact of prostate cancer screening on cancer-specific mortality.

SUBJECTS AND METHODS

Forty-six thousand four hundred and eighty-six (46,486) men aged 45–80 years registered in the electoral roll of the Quebec city area were randomized in 1988 between screening and no screening. Screening included measurement of serum prostatic specific antigen (PSA) using 3.0 ng/ml as upper limit of normal and digital rectal examination (DRE) at first visit. At follow-up visits, serum PSA only was used.

RESULTS

Seventy-four (74) deaths from prostate cancer occurred in the 14,231 unscreened controls while 10 deaths were observed in the screened group of 7,348 men during the first 11 years following randomization. Median follow-up of screened men was 7.93 years. A Cox proportional hazards model of the age at death from prostate cancer shows a 62% reduction (P < 0.002, Fisher's exact test) of cause-specific mortality in the screened men (P = 0.005). These results are in agreement with the continuous decrease of prostate cancer mortality observed in North America. © 2004 Wiley-Liss, Inc.

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