Evidence map›Paper›PMID 27911486›Full record

Trial reportCancer2017

Extended mortality results for prostate cancer screening in the PLCO trial with median follow-up of 15 years.

Paul F Pinsky, Philip C Prorok, Kelly Yu, Barnett S Kramer, Amanda Black, John K Gohagan, E David Crawford, Robert L Grubb, Gerald L Andriole

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 127 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
127citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

127 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
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  5. Atencion primaria · 2018
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67 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Paul F PinskyDivision of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Philip C ProrokDivision of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Kelly YuDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Barnett S KramerDivision of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Amanda BlackDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
John K GohaganOffice of Disease Prevention, National Institutes of Health, Bethesda, Maryland.
E David CrawfordDepartment of Surgery, University of Colorado School of Medicine, Aurora, Colorado.
Robert L GrubbDivision of Urology, Washington University School of Medicine, St. Louis, Missouri.
Gerald L AndrioleDivision of Urology, Washington University School of Medicine, St. Louis, Missouri.

Funding

University of Colorado NTCN Lead Academic Participating Site (LAPS) U10CA180834 · NCI · UNIVERSITY OF COLORADO DENVER · PI ELIAS, ANTHONY D · 2014 to 2018
$3.8M
Intramural NIH HHS Z99 CA999999NCI NIH HHS HHSN261201100008CNCI NIH HHS U10 CA180834
6 · The paper itself

Abstract

backgroundTwo large-scale prostate cancer screening trials using prostate-specific antigen (PSA) have given conflicting results in terms of the efficacy of such screening. One of those trials, the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, previously reported outcomes with 13 years of follow-up. This study presents updated findings from the PLCO trial.

methodsThe PLCO trial randomized subjects from 1993 to 2001 to an intervention or control arm. Intervention-arm men received annual PSA tests for 6 years and digital rectal examinations for 4 years. This study used a linkage with the National Death Index to extend mortality follow-up to a maximum of 19 years after randomization.

resultsMen were randomized to the intervention arm (n = 38,340) or the control arm (n = 38,343). The median follow-up time was 14.8 years (25th/75th, 12.7/16.5 years) in the intervention arm and 14.7 years (25th/75th, 12.6/16.4 years) in the control arm. There were 255 deaths from prostate cancer in the intervention arm and 244 deaths from prostate cancer in the control arm; this meant a rate ratio (RR) of 1.04 (95% confidence interval [CI], 0.87-1.24). The RR for all-cause mortality was 0.977 (95% CI, 0.950-1.004). It was estimated that 86% of the men in the control arm and 99% of the men in the intervention arm received any PSA testing during the trial, and the estimated yearly screening-phase PSA testing rates were 46% and 84%, respectively.

conclusionsExtended follow-up of the PLCO trial over a median of 15 years continues to indicate no reduction in prostate cancer mortality for the intervention arm versus the control arm. Because of the high rate of control-arm PSA testing, this finding can be viewed as showing no benefit of organized screening versus opportunistic screening. Cancer 2017;123:592-599. © 2016 American Cancer Society.

Indexed as

Early Detection of CancerAgedAmerican Cancer SocietyFollow-Up StudiesHumansMaleMiddle AgedProstate-Specific AntigenProstatic NeoplasmsProstate-Specific Antigendigital rectal examination (DRE)prostate cancerprostate-specific antigen (PSA)randomized trialscreening

Identifiers

PMID27911486
PMCPMC5725951

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.