Comparison of screen detected and clinically diagnosed prostate cancer in the European Randomized study of Screening for Prostate Cancer, section Rotterdam
Comparison of screen detected and clinically diagnosed prostate cancer in the European Randomized study of Screening for Prostate Cancer, section Rotterdam
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DOI：
10.1097/01.ju.0000162061.40533.0f
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发表时间：
2005-07-01
影响因子：
6.6
通讯作者：
Schröder, FH
中科院分区：
文献类型：
--
作者：
van der Cruijsen-Koeter, IW;Vis, AN;Schröder, FH
材料和方法：1993年12月至1999年1月，35,148名55~74岁的男性随机参加鹿特丹的欧洲前列腺癌筛查随机研究，其中筛查组17,635人，对照组17,513人。筛查组按2种算法进行前列腺特异性抗原检测、直肠指诊、经直肠超声和六分镜活检。所有筛查发现的癌症和在对照组中发现的癌症都在同一截止点进行评估，即2003年1月1日。为了确定对照组中的前列腺癌病例，每年与鹿特丹癌症登记数据库建立联系。结果：截至2003年1月1日，筛查组共检出癌症1269例，对照组检出肿瘤336例。在试验的筛选臂中，可以看到活检转移到更有利的临床分期和组织学分级。在试验的筛查组中，T1C和T2癌症的确诊频率分别是对照组的5.8倍和6.2倍。只有4.6%的对照臂癌症是通过机会性筛查发现的。结论：尽管试验的筛查分支的预后因素出现了有利的转变，但这些结果并不能提供前列腺癌筛查对前列腺癌死亡率有影响的证据。
Purpose: This report provides a comparison of characteristics detected in the screening and control arms of the European Randomized study of Screening for Prostate Cancer, section Rotterdam.Materials and Methods: Between December 1993 and January 1999, 35,148 men 55 to 74 years old were randomized to European Randomized study of Screening for Prostate Cancer Rotterdam, including 17,635 in the screening arm and 17,513 in the control arm. Prostate specific antigen testing, digital rectal examination, transrectal ultrasound and sextant biopsies were offered to all participants in the screening arm according to 2 algorithms. All screening detected cancers and cancers found in the control arm were evaluated at the same cutoff point, that is January 1, 2003. To identify prostate cancer cases in the control arm yearly linkage was performed with the Rotterdam Cancer Registry database. Followup information was collected by chart review.Results: By January 1, 2003, 1,269 cancers were detected in the screening arm and 336 were detected in the control arm. A shift to more favorable clinical stages and histological grades on biopsy was seen in the screening arm of the trial. T1C and T2 cancers were 5.8 and 6.2 times more often diagnosed, respectively, in the screening arm than in the control arm of the trial. Only 4.6% of control arm cancers were found through opportunistic screening.Conclusions: Although a favorable shift in prognostic factors was seen for the screening arm of the trial, these results do not provide evidence that prostate cancer screening has an effect on prostate cancer mortality.