Screening decreases prostate cancer death: First analysis of the 1988 Quebec Prospective Randomized Controlled Trial

Labrie, Fernand; Candas, Bernard; Dupont, André; Cusan, Lionel; Gomez, José‐Luis; Suburu, Raul; Diamond, P.; Lévesque, Julie; Bélanger, Alain

doi:10.1002/(sici)1097-0045(19990201)38:2<83::aid-pros1>3.0.co;2-b

Cited by 279 publications

(160 citation statements)

References 35 publications

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“…This was the Quebec 1988 screening trial of 46 193 men, which showed a significant fall in the prostate cancer-specific death rate from 49/100 000 to 15/100 000. 6 However, this study has attracted criticism for its statistical methods, central to which was the fact that only 23% of the trial population were willing to participate and that there was compromise of the randomisation process between groups. Recently, a new analysis of the Quebec population has shown that there was no correlation between the decrease in mortality and PSA screening.…”

Section: Discussionmentioning

confidence: 99%

PSA testing in general practice

Little

Gormley

et al. 2003

Prostate Cancer Prostatic Dis

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A questionnaire was sent to 400 general practitioners (GPs), concerning prostatespecific antigen (PSA) screening. Regarding the indications for PSA testing, 80% of GPs test men with urinary tract symptoms, 65% test men with a positive family history, 62% test on patient request, and 21% test men with unrelated symptoms. When PSA is measured, 91% of GPs inform their patient, and 71% discuss the significance of an abnormal result. The mean age range for PSA testing was from 50 years, without an upper age limit. The mode PSA threshold for referral was 6.6 ng/ml. De facto PSA screening appears to be widely practised.

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Section: Discussionmentioning

confidence: 99%

PSA testing in general practice

Little

Gormley

et al. 2003

Prostate Cancer Prostatic Dis

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“…[4][5][6] Likewise, the efficacy of adjuvant hormonal therapy (HT) following surgery or radiation but not HT alone in CaP has been demonstrated in numerous RCTs with inconsistent results. [7][8][9][10][11][12][13] These studies showed a significant reduction in a 5-year follow-up for CaP-specific mortality, with survival benefit ranging from 37 to 81%. For example, a study observed a 59% decrease in cancer-specific mortality in patients with Gleason score of 8-10, 12 while another study, though not statistically significant, found a 39% reduction in CaP-specific mortality comparing luteinizing hormone-releasing hormone (LHRH) agonist plus radiation with radiation only regimen.…”

Section: Introductionmentioning

confidence: 91%

Effectiveness of androgen deprivation therapy in prolonging survival of older men treated for locoregional prostate cancer

Holmes

Chan

Jiang

et al. 2007

Prostate Cancer Prostatic Dis

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Epidemiologic and experimental evidence suggests the effectiveness of androgen deprivation therapy (ADT) in prostate cancer (CaP) management. Although ADT has been increasingly used as mono-therapy in CaP, the survival benefit of ADT remains unclear. We examined the effectiveness of ADT in prolonging survival in a community-based cohort of 64 475 older men diagnosed with locoregional CaP, in 1992-1999 with last follow-up through December 2002, in 11 Surveillance Epidemiology and End Results (SEER) registries. The effect of ADT on survival was assessed using Kaplan-Meier's method, log-rank test and Cox proportional hazards. After adjustment for propensity to receive ADT, the ADT and non-ADT groups were significantly different in the distribution of covariates except for comorbidity score and SEER registries. The crude overall mortality was significantly higher in cases with ADT compared with cases that received no ADT, hazard ratio (HR ¼ 1.54; 95% CI ¼ 1.50-1.58). However, mortality was substantially reduced (1.04, 1.00-1.08) after adjusting for standard care, socio-demographics, tumor characteristics, prognostic factors and chemotherapy. Therefore, ADT was not associated with significantly increased survival benefit for older men with locoregional CaP. Further studies may be needed to explore whether ADT is associated with other health benefits and the cost-effectiveness of these benefits.

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“…While theoretically sound, in practical terms many physicians do not take the time or have the time for such counseling and the screening may or may not be done based on the bias of the practice. Furthermore, in light of new`stage migration' data in the PSA era 24,25 and even one randomized trial reporting a bene®t to population-based screening, 26 the pros and con discussion is controversial. Speci®cally, should clinicians give the`bene®t-of-doubt' that screening may improve long-term outcome or emphasize the uncertainty.…”

Section: Knowledge and Attitudesmentioning

confidence: 99%

Targeted screening for prostate cancer in African-American men

2000

Prostate Cancer Prostatic Dis

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Screening decreases prostate cancer death: First analysis of the 1988 Quebec Prospective Randomized Controlled Trial

Cited by 279 publications

References 35 publications

PSA testing in general practice

PSA testing in general practice

Effectiveness of androgen deprivation therapy in prolonging survival of older men treated for locoregional prostate cancer

Targeted screening for prostate cancer in African-American men

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