In the screening group, rates of compliance were 85% for PSA testing and 86% for DRE. Rates of screening in the control group increased from 40% in the first year to 52% in the sixth year for PSA testing and ranged from 41% to 46% for DRE. Results from the first four rounds of screening are shown in the Summary of First Four Prostate, Lung, Colorectal, and Ovarian Screening Rounds table.
Summary of First Four Prostate, Lung, Colorectal, and Ovarian Screening Roundsa
DRE = digital rectal exam; PSA = prostate-specific antigen; T = tumor.
a Adapted from Grubb et al.
|Number Tested (PSA or DRE)||34,262 ||32,696||31,697||30,544|
|PSA positive (>4 ng/mL) (%)||7.9 ||7.7||8.2||8.8|
|DRE positive (%)||7.2 ||6.8||7.3||7.6|
|Either test positive (%)||14.0 ||13.5||14.4||15.1|
|Biopsies and Cancers||�||�||�||�|
|PSA >4 ng/mL||2,718 ||2,502||2,593||2,676|
|Cancers/1,000 screened||14.2 ||9.4||8.5||9.3|
|DRE abnormal and PSA ?4 ng/mL||2,083 ||1,923||1,973||1,943|
|Cancers/1,000 screened||1.8 ||2.1||2.3||1.9|
|PSA >4 ng/mL or DRE abnormal||4,801 ||4,425||4,566||4,619|
|Cancers/1,000 screened ||16.0 ||11.5||10.8||11.1|
After 7 years of follow-up, with vital status known for 98% of men, the incidence of prostate cancer per 10,000 person-years was 116 (2,820 cancers) in the screening group and 95 (2,322 cancers) in the control group (rate ratio, 1.22; 95% CI, 1.16-1.29). The incidence of death per 10,000 person-years was 2.0 (50 deaths) in the screening group and 1.7 (44 deaths) in the control group (rate ratio, 1.13; 95% CI, 0.75-1.70). The data at 10 years were 67% complete and consistent with these overall findings (incidence rate ratio, 1.17; 95% CI, 1.11-1.22 and mortality rate ratio, 1.11; 95% CI, 0.83-1.50). Thus, after 7 to 10 years of follow-up, the rate of death from prostate cancer was very low and did not differ significantly between the two study groups.
At 7 years, the total numbers of deaths (excluding those from prostate, lung, or colorectal cancers) were 2,544 in the screening group and 2,596 in the control group (rate ratio, 0.98; 95% CI, 0.92-1.03); at 10 years, the numbers of such deaths were 3,953 and 4,058, respectively (rate ratio, 0.97; 95% CI, 0.93-1.01). The distribution of the causes of death was similar in the two groups.