Three-Year Results of the Finnish Prostate Cancer Screening Trial

Abstract

Prostate cancer screening is increasing despite lack of demonstrated effectiveness (1). Large randomized, controlled trials with long-term follow-up are ongoing in Europe and North America to assess the effects of screening on mortality and quality of life (2). The Finnish trial is a part of the European Randomized Study of Screening for Prostate Cancer, a multicenter trial with eight participating centers (3). The common core protocol includes enrollment of men at age 55–67 years and a screening test to assay the concentration of prostate-specific antigen (PSA) in serum, with a PSA cutoff point of 4.0 ng/mL. We report here the attendance rate, the specificity, and the detection rate of prostate cancer during the first 3 years of the prevalence screening round. These parameters are intermediate indicators and thus are necessary, but are not sufficient, conditions for effective screening. The target population of the Finnish prostate cancer screening trial consists of men born during the period from 1929 through 1944 who reside in the metropolitan areas of Helsinki or Tampere, Finland. During the first 3 years of the study (1996–1998), 60 211 men aged 55–67 years were identified from the Population Registry of Finland. Information on prostate cancers was obtained through a record linkage with the Finnish Cancer Registry, and men with prevalent prostate cancer were excluded from the study before randomization (n = 238).