Evidence map›Paper›PMID 28803925›Full record

Trial reportEuropean urology focus2019

Impact of Prostatic-specific Antigen Threshold and Screening Interval in Prostate Cancer Screening Outcomes: Comparing the Swedish and Finnish European Randomised Study of Screening for Prostate Cancer Centres.

Lasse Saarimäki, Jonas Hugosson, Teuvo L Tammela, Sigrid Carlsson, Kirsi Talala, Anssi Auvinen

Abstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in European urology focus, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lasse SaarimäkiUniversity of Tampere, School of Medicine, Tampere, Finland. Electronic address: Lasse.saarimaki@fimnet.fi.
Jonas HugossonDepartment of Urology, Sahlgrenska University Hospital, Göteborg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Sweden.
Teuvo L TammelaUniversity of Tampere, School of Medicine, Tampere, Finland; Department of Urology, Tampere University Hospital, Tampere, Finland.
Sigrid CarlssonInstitute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Sweden; Urology Service at the Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA.
Kirsi TalalaFinnish Cancer Registry, Helsinki, Finland.
Anssi AuvinenUniversity of Tampere, School of Health Sciences, Tampere, Finland.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundThe European Randomised Study of Screening for Prostate Cancer trial has shown a 21% reduction in prostate cancer (PC) mortality with prostate-specific antigen (PSA)-based screening. Sweden used a 2-yr screening interval and showed a larger mortality reduction than Finland with a 4-yr interval and higher PSA cut-off.

objectiveTo evaluate the impact of screening interval and PSA cut-off on PC detection and mortality. DESIGN, SETTING, AND

participantsWe analysed the core age groups (55-69 yr at entry) of the Finnish (N=31 866) and Swedish (N=5901) screening arms at 13 yr and 16 yr of follow-up. Sweden used a screening interval of 2 yr and a PSA cut-off of 3.0ng/ml, while in Finland the screening interval was 4 yr and the PSA cut-off 4.0ng/ml (or PSA 3.0-3.9ng/ml with free PSA<16%). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We compared PC detection rate and PC mortality between the Finnish and Swedish centres and estimated the impact of different screening protocols. RESULTS AND LIMITATIONS: If the Swedish screening protocol had been followed in Finland, 122 additional PC cases would have been diagnosed at screening, 84% of which would have been low-risk cancers, and four leading to PC death. In contrast, if a lower PSA threshold had been applied in Finland, at least 127 additional PC would have been found, with 19 PC deaths.

conclusionsThe small number of deaths among cases that would have been potentially detectable in Finland with the Swedish protocol (or those that would have been missed in Sweden with the Finnish approach) is unlikely to explain the differences in mortality in this long of a follow-up. PATIENT SUMMARY: A prostate-specific antigen threshold of 3ng/ml versus 4ng/ml or a screening interval of 2 yr instead of 4 yr is unlikely to explain the larger mortality reduction achieved in Sweden compared with Finland.

Indexed as

Early Detection of CancerFinlandHumansIncidenceMaleMass ScreeningMiddle AgedProstate-Specific AntigenProstatic NeoplasmsSwedenProstate-Specific AntigenProstate cancerProstate-specific antigenRandomised trialsScreening

Identifiers

PMID28803925
PMCPMC5809235

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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.