Abstract
Background
There is no available evidence from randomized trials that early detection of prostate cancer improves health outcomes, but the prostate-specific antigen (PSA) test is commonly used to screen men for prostate cancer.
Objective
The objective of the study is to see if screening with PSA decreases mortality from prostate cancer.
Design, setting, and participants
This is a case-control study using one-to-one matching on race, age, and time of availability of exposure to PSA screening. Decedents, 380, from New Jersey Vital Statistics 1997 to 2000 inclusive, 55–79 years of age at diagnosis were matched to living controls without metastatic prostate cancer. Medical records were obtained from all providers, and we abstracted information about PSA tests from 1989 to the time of diagnosis in each index case.
Measurements
Measurements consist of a comparison of screening (yes, no) between cases and controls. Measure of association was the odds ratio.
Results
Eligible cases were diagnosed each year from 1989 to 1999 with the median year being 1993. PSA screening was evident in 23.2–29.2% of cases and 21.8–26.1% of controls depending on the screening criteria. The unadjusted, matched odds ratio for dying of prostate cancer if ever screened was 1.09 (95% CI 0.76 to 1.60) for the most restrictive criteria and 1.19 (95% CI, 0.85 to 1.66) for the least restrictive. Adjustment for comorbidity and education level made no significant differences in these values. There were no significant interactions by age or race.
Conclusions
PSA screening using an ever/never tabulation for tests from 1989 until 2000 did not protect New Jersey men from prostate cancer mortality.
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Acknowledgements
The authors thank Betsy A. Kohler, MPH, CTR, Director of Cancer Epidemiology Services, NJDHSS for help with obtaining registry records; Eddy A. Bresnitz, MD, MS, Deputy Commissioner/State Epidemiologist, NJDHSS for facilitating the cooperation of physicians; Janet B. Schoenberg, MPH, MPhil, for help with the initial planning of the study; Antonio M. Savillo, MD for communicating with the hospital tumor registrars; and Orlando Mills, MD, MPH for his writing of the grant in support of the study and for initial pilot work. Stephen Marcella, George Rhoads, and Jeffrey Carson received financial support from the National Cancer Institute Grant: NCI-RO1 CA71734-01A1.
Conflict of Interest
None of the authors have any conflict of interest to declare. The funding agency did not have a role in any aspect of the study including data collection, analysis, preparation of the manuscript, or the decision to publish.
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This study was presented at a poster session at the Annual Meeting on Cancer Prevention of the American Association for Cancer Research, November 14th, 2006 in Boston, USA.
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Marcella, S.W., Rhoads, G.G., Carson, J.L. et al. Prostate-Specific Antigen Screening and Mortality from Prostate Cancer. J GEN INTERN MED 23, 248–253 (2008). https://doi.org/10.1007/s11606-007-0479-7
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DOI: https://doi.org/10.1007/s11606-007-0479-7