The pendulum of prostate cancer screening
A partir des données des registres américains du cancer entre 2005 et 2012 et de données issues d'enquêtes nationales de santé, ces deux études analysent l'évolution de l'incidence du cancer de la prostate et de la prescription de tests PSA après la publication, en 2008, de recommandations d'un groupe d'experts sur le dépistage du cancer de la prostate
Two large randomized clinical trials studying the effectiveness of prostate cancer screening have been completed to date. In the United States, the prostate component of the Prostate, Lung, Colorectal, and Ovarian (PLCO) study failed to show a survival benefit for prostate cancer screening. However, participants in the control group of PLCO underwent an average of 2.7 PSA tests and 74% had at least 1 PSA test during the study period, leading many to suggest that this was not a valid comparison of screening with no screening. A second large study, the European Randomized Study of Screening for Prostate Cancer (ERSPC), with less contamination of the control group, showed a benefit to PSA screening, although the effect size was relatively small and the risk of overdiagnosis and overtreatment associated with screening remained substantive.
JAMA , éditorial, 2014