Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials
Authors: Stuart G. Baker
Journal: Annals of Internal Medicine (2018)

Letters17 April 2018Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO TrialsStuart G. Baker, ScDStuart G. Baker, ScDNational Cancer Institute, Bethesda, Maryland (S.G.B.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0736 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Tsodikov and colleagues' (1) results on the effects of PSA screening on prostate cancer mortality may give a distorted view of the evidence. The standard method for the analysis of clinical trials is to analyze by intention-to-treat because this method uses randomization to reduce bias from unmeasured confounders. On the basis of data from Table 1 of their article, screening decreased prostate cancer deaths by 9 (95% CI, −15 to −3) per 10 000 persons in the ERSPC and increased it by 1 (CI, −7 to 8) per 10 000 persons in the PLCO. These results suggest a small ...References1. Tsodikov A, Gulati R, Heijnsdijk EAM, Pinsky PF, Moss SM, Qiu S, et al. Reconciling the effects of screening on prostate cancer mortality in the ERSPC and PLCO trials. Ann Intern Med. 2017;167:449-55. [PMID: 28869989]. doi:10.7326/M16-2586 LinkGoogle Scholar2. Pinsky PF, Blacka A, Kramer BS, Miller A, Prorok PC, Berg C. Assessing contamination and compliance in the prostate component of the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Clin Trials. 2010;7:303-11. [PMID: 20571134] doi:10.1177/1740774510374091 CrossrefMedlineGoogle Scholar3. Wolters T, Roobol MJ, Steyerberg EW, van den Bergh RC, Bangma CH, Hugosson J, et al. The effect of study arm on prostate cancer treatment in the large screening trial ERSPC. Int J Cancer. 2010;126:2387-93. [PMID: 19739124] doi:10.1002/ijc.24870 CrossrefMedlineGoogle Scholar4. Andriole GL, Crawford ED, Grubb RL, Buys SS, Chia D, Church TR, et al; PLCO Project Team. Prostate cancer screening in the randomized Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial: mortality results after 13 years of follow-up. J Natl Cancer Inst. 2012;104:125-32. [PMID: 22228146] doi:10.1093/jnci/djr500 CrossrefMedlineGoogle Scholar5. Freedman DA, Petitti DB, Robins JM. On the efficacy of screening for breast cancer. Int J Epidemiol. 2004;33:43-55. [PMID: 15075144] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: National Cancer Institute, Bethesda, Maryland (S.G.B.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0736. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoReconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials Alex Tsodikov , Roman Gulati , Eveline A.M. Heijnsdijk , Paul F. Pinsky , Sue M. Moss , Sheng Qiu , Tiago M. de Carvalho , Jonas Hugosson , Christine D. Berg , Anssi Auvinen , Gerald L. Andriole , Monique J. Roobol , E. David Crawford , Vera Nelen , Maciej Kwiatkowski , Marco Zappa , Marcos Luján , Arnauld Villers , Eric J. Feuer , Harry J. de Koning , Angela B. Mariotto , and Ruth Etzioni Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials Shinkan Tokudome , Ryosuke Ando , and Shuji Hashimoto Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials Alex Tsodikov , Roman Gulati , and Ruth Etzioni Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials Philippe Autier and Peter Boyle Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials Join Y. Luh , Steven E. Finkelstein , Jeff M. Michalski , and Howard Sandler MD Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials Philip C. Prorok and Anthony B. Miller Metrics 17 April 2018Volume 168, Issue 8Page: 606-607KeywordsCancer screeningClinical trialsConflicts of interestDeath ratesDisclosureIntent to treat analysisMammographyMortalityProstate cancerRisk management ePublished: 17 April 2018 Issue Published: 17 April 2018 PDF downloadLoading ...