The ERSPC study shows a significant reduction in the relative risk of death from prostate cancer by 20% in the age group 55 to 69 years. More generally, in the whole age group from 50 to 74 years, the reduction in relative risk has been 27% and an even greater reduction is expected with longer periods of monitoring.
The ERSPC study was launched in 1993 following preliminary studies in seven European countries. The study covered 182 000 men aged 50 – 74. These men were divided into two groups, one of 72890 with detection from PSA testing every four years and the other with no tests.
An age group of 55 to 69 years comprising 162 387 men was more specifically targeted in the study.
Prostate biopsies detected 5990 prostate cancers in the group tested against 4307 in the control group, indicating after a delay of 8.8 years a rate of 8.8 % of prostate cancer in the control group against 4.8% in the control group. There were 214 deaths from prostate cancer in the group tested against 326 in the control group. Detection led to the avoidance of seven deaths per 10 000 men.
Results were similar in all the centres participating in the study.
The rate of over-diagnosis of prostate cancer, defined as that corresponding to diagnoses on men who never had clinical symptoms of cancer during their whole lives, was estimated at 50% in the group tested
OFrom the results of the study, we conclude that men requiring an individual detection of prostate cancer should be advised of the following:
- If they have prostate cancer, early detection reduces the death rate from this cancer by 27% ;
- – There is a risk of carrying out a diagnosis and treating an ailment which would never have developed symptoms.
- If an ‘insignificant cancer is diagnosed, which is identifiable in about 50% of cases, radical treatment can be avoided by active monitoring.