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Urol Clin North Am. 2014 May;41(2):223-8. doi: 10.1016/j.ucl.2014.01.002. Epub 2014 Feb 19.

What do the screening trials really tell us and where do we go from here?

Author information

  • 1Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M2-B230, PO Box 19024, Seattle, WA 98109-1024, USA. Electronic address:
  • 2The Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, MC-7845, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA.


Publication of apparently conflicting results from 2 large trials of prostate cancer screening has intensified the debate about prostate-specific antigen (PSA) testing and has led to a recommendation against screening from the US Preventive Services Task Force. This article reviews the trials and discusses the limitations of their empirical results in informing public health policy. In particular, the authors explain why harm-benefit trade-offs based on empirical results may not accurately reflect the trade-offs expected under long-term population screening. This information should be useful to clinicians in understanding the implications of these studies regarding the value of PSA screening.

Copyright © 2014 Elsevier Inc. All rights reserved.


Clinical trials; Mass screening; Prostate cancer; Prostate-specific antigen; Public health policy; Simulation modeling

[PubMed - indexed for MEDLINE]
[Available on 2015-05-01]
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