Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Urol. Nov 24, 2015; 4(3): 97-99
Published online Nov 24, 2015. doi: 10.5410/wjcu.v4.i3.97
Nothing like data showing significant death reduction can better support prostate cancer screening
Fernand Labrie
Fernand Labrie, Research Center, the University Hospital of Quebec, Laval University, Quebec G1V 4M7, Canada
Author contributions: Labrie F designed and performed part of research, analyzed data and wrote the paper.
Conflict-of-interest statement: Fernand Labrie declares no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Fernand Labrie, MD, PhD, Emeritus Professor, Research Center, the University Hospital of Quebec, Laval University, 2795 Laurier Blvd, Suite 500, Quebec G1V 4M7, Canada. fl@fernandlabrie.com
Telephone: +1-418-6530055 Fax: +1-418-6411856
Received: February 21, 2015
Peer-review started: February 22, 2015
First decision: May 13, 2015
Revised: May 29, 2015
Accepted: July 21, 2015
Article in press: July 23, 2015
Published online: November 24, 2015
Abstract

At 13 years of follow-up, the European Randomized Study of Screening for Prostate Cancer shows a 21% decrease in prostate cancer deaths in the prostate-specific antigen-screened group compared to control. This difference increases to 27% when non compliance is taken into account. The benefits of screening compared to control are higher at 28% (compared to 21%) when duration of follow-up ranges between 8 and 12 years. Such data obtained following an average rate of one screening performed once every 5.7 years in quite impressive and strongly supports the use of screening for a successful fight against a cancer which grows to an advanced and non curable stage without any specific sign or symptom.

Keywords: Prostate cancer, Screening, Prostate-specific antigen, Early diagnosis, Early treatment

Core tip: The wide use of prostate-specific antigen for screening of prostate cancer is a major issue preventing the recruitment of true unscreened controls in studies on prostate cancer screening. This is why only studies performed some time ago can meet this requirement of a small contamination of the control group. The European Randomized Study on Screening for Prostate Cancer had a contamination of 23%-40%, thus permitting to see, at 13 years of follow-up, a 21% decrease in prostate cancer deaths in the screened group compared to no screening. The earlier Quebec trial had a contamination of only 7% with a 62% decrease in death from prostate cancer at a median follow-up of 7.9 years. A contamination of 85% of the control group prevented the United States PLCO trial from providing reliable data. The data obtained in the European and Quebec trials are strong arguments for a major positive impact of early diagnosis which needs screening for a successful fight against prostate cancer.