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

Authors

  • Fernand Labrie,

    Corresponding author
    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.
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  • Bernard Candas,

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

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

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

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

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

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

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