Influence of blood prostate specific antigen levels at age 60 on benefits and harms of prostate cancer screening: Population based cohort study

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift


Objective To determine the relative risks of prostate cancer incidence, metastasis, and mortality associated with screening by serum prostate specific antigen (PSA) levels at age 60. Design Population based cohort study. Setting General male population of Sweden taking part in a screening trial in Gothenburg or participating in a cardiovascular study, the Malmo Preventive Project. Participants The screened group consisted of 1756 men aged 57.5-62.5 participating in the screening arm of the Gothenburg randomized prostate cancer screening trial since 1995. The unscreened group consisted of 1162 men, born in 1921, participating in the Malmo Preventive Project, with PSA levels measured retrospectively in stored blood samples from 1981. Intervention PSA screening versus no screening. Main outcome measures Incidence rate ratios for the effect of screening on prostate cancer diagnosis, metastasis, and death by PSA levels at age 60. Results The distribution of PSA levels was similar between the two cohorts. Differences in benefits by baseline PSA levels were large. Among men with baseline levels measured, 71.7% (1646/2295) had a PSA level 2 ng/mL at age 60 is beneficial, with the number needed to screen and treat being extremely favourable. Screening men with a PSA level of 1-2 ng/mL is an individual decision to be based on a discussion between patient and doctor.


  • Sigrid Carlsson
  • Melissa Assel
  • Daniel Sjoberg
  • David Ulmert
  • Jonas Hugosson Prof.
  • Hans Lilja
  • Andrew Vickers
Enheter & grupper
Externa organisationer
  • Göteborgs universitet
  • Memorial Sloan-Kettering Cancer Center

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Cancer och onkologi
TidskriftB M J: British Medical Journal
StatusPublished - 2014 mar 28
Peer review utfördJa