Insights from the PLCO trial about prostate cancer screening.

Abstract

The potential for prostate-specific antigen (PSA) testing to reduce prostate cancer mortality has been uncertain despite its common use in the United States starting in the early 1990s. Updated results from the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial after a median of 15 years of follow-up continue to show no reduction in prostate cancer mortality due to annual PSA testing for 4–6 years relative to usual care, which included less frequent PSA testing. In contrast with trials in Europe, which showed that certain PSA testing protocols can reduce prostate cancer mortality relative to not screening, the PLCO trial provides durable evidence of no benefit to screening more frequently than historical practice. Whether a limited population-based screening program can achieve an acceptable balance of benefit and harm remains to be determined.