Long-Term Outcome of a Single Intervention Population Based Prostate Cancer Screening Study

Purpose: We evaluated the long-term effect of screening for prostate cancer.Materials and Methods: In 1988 we randomly selected 2,400 men from a background population of 27,464 men. The 2,400 men were invited to undergo screening, of whom 1,779 (74%) accepted and were examined with digital rectal examination, ultrasound and prostate specific antigen measurement. Biopsy was performed if there were suspicious findings on ultrasound or digital rectal examination, or prostate specific antigen was greater than 10 ng/ml. The subpopulations have now been reassessed after 20 years.Results: Participants had a decreased overall mortality rate compared to the source population (IRR 0.93, 95% CI 0.86–0.98). Nonparticipants had an increased overall mortality rate (IRR 1.25, 95% CI 1.14–1.37). There was no difference between the groups in prostate cancer specific survival. The incidence of prostate cancer remained higher in the screened population throughout followup.Conclusions: A single screening intervention in men ...