From Dr. Cantalona's Quest Publication....His comments on the study
that seems to be getting a lot of US Media attention showing no
benefit to prostate cancer screening.
Two Studies

The Spring 2009 issue of QUEST was devoted to the subject of prostate
cancer screening in response to the high interest in the topic created
by the publication of two studies in the New England Journal of
Medicine. (Articles from that QUEST are available on the URF website: The European Screening Trial (ERSPC) provides
conclusive evidence that PSA screening can save lives; whereas, the
United States trial (PLCO) essentially contains no useful information.

Moreover, it is likely that the mortality benefit in ERSPC is an
underestimate because of the relatively short follow-up, the
relatively long screening interval, the non-use of digital rectal exam
as a screening test after the first round, and contamination in the
control arm.

In contrast, it is unlikely that the misleading PLCO results will
change substantially with further follow-up because the study was
fatally flawed from the beginning. The basic flaws included:

1. 43% of the study group was prescreened, eliminating high-risk
Prostate cancer from the study population.

2. 52% of the control population was screened during the study thereby
contaminating the actual results.

3. No requirement was made for men with abnormal screening results to
undergo biopsy and only 40% of those identified did, thus compromising
early detection and treatment

4. It takes patients about 13 years after recurrence following a
radical prostatectomy to die of prostate cancer, but the median follow
up for men with cancer in the PLCO was 5-6 years, insufficient to
evaluate mortality results and

5. Men were included up to age 74 and they are less likely to have a
mortality benefit from screening.