• prostate neoplasm;
  • biopsy;
  • diagnosis;
  • PSA;
  • Internet;
  • mass media

What’s known on the subject? and What does the study add?

The media is a powerful tool and the policy makers as well as the public are highly susceptible to media reporting of events. The interpretation of the two large randomised prostate cancer trials (ERSPC and PLCO) published in the NEJM in 2009 were conflicted in their results regarding the benefits of screening. What is agreed upon is that the methodology for the PLCO trial was somewhat flawed but also that both trials were reported on too early – prostate cancer has an extraordinarily long leadtime and time to mortality from diagnosis.

The paper adds valuable data for the first time a comprehensive prospective analysis of the established print media (online version) reporting across the UK versus north America (USA and Canada) and also Australasia as well as online-only reporting observed the reporting of the trials and how they interpreted the conflicting study results from March 2009. Interestingly geographical bias as anticipated was reported-North America media against screening predominantly and europe (UK) for it whilst Australasia rested between. Urological and related bodies need to be aware of such geographical media bias in when and how they report and publish articles and the imapact they may ultimately have on public awareness and health policy.


• The publication of two large screening studies for prostate cancer (CaP), the Prostate Lung Colorectal Ovarian Cancer (PLCO) and the European Randomized Study of Screening for Prostate Cancer (ERSPC), has generated intense interest in medical and lay press not only as a result of their robust size, but also their opposing outcomes and differing methodologies, making interpretation controversial.

• To characterize the world online media response to the studies by assessing reports for quality and message, as well as noting geographical differences.


• Major newspapers in North America, UK and Australia reporting online and Internet-only news organizations were analyzed for their reporting of CaP screening in response to the trials for a period of 6 months post-release.

• Content, positive or negative projection regarding screening, and use of expert commentary were recorded.

• Statistical analysis of the results was then undertaken.


• In total, 48 newspapers reported the CaP screening studies with a median (range) publication time for newsprint online of 1.5 (0–175) days and same day appearance for online news sources in the range 0–110 days.

• Only 23% of newsprint articles indicated that screening was a positive endeavour, whereas 31% were negative and the remainder were neutral (46%).

• Some 78% of UK articles indicated insufficient screening, whereas 57% in the USA and 80% in Canada reported screening as being excessive. Online media reflected USA reporting.


• World newsprint media in general portrayed screening in a negative light after publication of the ERSPC and PLCO studies.

• North American media concluded that prostate-specific antigen (PSA) screening was excessive, whereas the UK media indicated that an inadequate level of PSA screening is occurring.

• The media influences public opinion and government policy and it is important that urological organizations are aware of the true impact.