The importance of this has been shown by previous research that suggests that the cause of death is less likely to be reported as related to prostate cancer when the subject is receiving attempted curative treatment for the disease.4 The majority of

cancers found were diagnosed at stage II, were nearly all adenocarcinomas, and more than 50% had a Gleason score of 5 to 6. These findings did not differ between the screening Inhibitors,research,lifescience,medical and control group. More advanced-stage cancer diagnoses (stage III or IV) were also similar between the 2 groups, although Gleason scores of 8 to 10 were higher in the control group (341) than in the screening group (289). These results show that, after an average 7 years of follow-up, the mortality did not significantly differ between the 2 groups. Therefore, in this study, screening was not associated with mortality (rate ratio, 1.13). Table 3 Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Inhibitors,research,lifescience,medical Trial Results at 10 Years Discussion The ERSPC and PLCO trials are extraordinary data sets. Their analysis is highly complex and provides remarkable clarity to the results

and conclusions. The magnitude Inhibitors,research,lifescience,medical of patients enrolled, 182,000 and 76,693 men in the ERSPC and PLCO trials, respectively, is unprecedented. The randomization of patients was highly sophisticated in both trials, Inhibitors,research,lifescience,medical with methodologies resulting in near-perfect distributions of men. This was retested in the ERSPC trial, where age distributions and death rates from all causes were compared in the screening and control Rapamycin ic50 groups throughout the study period. Patient compliance was very high, and is made more impressive by the length of the study period. The PLCO trial had especially high levels Inhibitors,research,lifescience,medical of compliance (Table 4): at 7 years vital status was known for 98% of participants, and at 10 years it was known for 67%. The compliance rates for testing were additionally very high, 85% for PSA and 86%

for DRE. In the ERSPC trial, 82.2% of men in the screening group were screened at least once, and overall compliance was better in those study centers that had obtained consent before the beginning of the study (88%–100%) than in those that underwent randomization before obtaining consent (62%–68%). The follow-up and compliance data lay the groundwork for an extremely comprehensive population analysis. Table 4 Prostate, Lung, Colorectal, and Ovarian Dipeptidyl peptidase (PLCO) Cancer Screening Trial Rate of Screening and Compliance The long follow-up is especially important in the study of prostate cancer, which is often very slow to develop, especially in older men. Follow-up times of 9 and 10 years for the ERSPC and PLCO trials, respectively, are useful and necessary, especially for large populations. The PLCO study will continue to an estimated follow-up of at least 13 years.