Table 1:

Evidence of benefit of screening for prostate cancer with PSA testing

Study (country)Study characteristicsPSA threshold, ng/mLContamination (rate of screening in control group), %Prostate cancer mortality, RR (95% CI)All-cause mortality, RR (95% CI)Absolute effectGRADE quality of evidence*
PLCO21 (United States)RCT; 76 693 men aged 55–74 yr; annual PSA screening for 6 yr and digital rectal examination annually for 4 yr; 14-yr follow-up4521.09 (0.87–1.36)0.96 (0.93–1.00)No effectModerate
ERSPC19 (Finland, Sweden, Italy, the Netherlands, Belgium, Spain and Switzerland)RCT; 162 243 men aged 50–74 yr (core group 55–69 yr); PSA screening every 4 yr; 13-yr follow-up3.0 at most sites20Core group: 0.79 (0.69–0.91)
All ages: 0.83 (0.73–0.94)
Core group: 1.00 (0.98–1.02)
All ages: 1.00 (0.98–1.02)
12.8 fewer deaths per 10 000 men screenedModerate
  • Note: CI = confidence interval, ERSPC = European Randomized Study of Screening for Prostate Cancer, PLCO = Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, PSA = prostate-specific antigen, RCT = randomized controlled trial, RR = relative risk.

  • * GRADE (Grading of Recommendations, Assessment, Development and Evaluation)15 rates the continuum of quality of evidence in 4 categories of high, moderate, low or very low; see evidence review for complete assessment of study quality.13