Cancer detection in the European Randomised Study of Screening for Prostate Cancer (ERSPC).

In 30 seconds

This analysis of the multicentre European Randomised Study of Screening for Prostate Cancer examined cancer detection across three screening cycles among men aged 55–69 years at trial centres other than France. It compared detection by cancer grade and centre, and also considered interval cancers and non-attendance. Among screen-detected cases, low-grade cancer detection rates were consistently higher than rates for intermediate- and high-grade cancer. High-grade detection trends varied across centres, generally falling in the second cycle and rising in the third, while increasing at each cycle in Spain.

Key findings

• Across centres and all three screening cycles, detection rates were consistently higher for low-grade than for intermediate- or high-grade screen-detected cancer.
• High-grade detection rates generally decreased from the first to second cycle and rose in the third; in Spain, they increased with each cycle.
• The authors report decreasing low-grade detection and substantial between-centre variation in intermediate- and high-grade detection across repeated rounds.
• Increasing interval and non-attender cancers were interpreted as indicating diminishing effectiveness of uniform screening schedules.

Why it matters

Detection patterns changed across screening rounds and differed between centres, while low-grade cancers were detected more often than higher-grade cancers. These findings highlight the importance of considering cancer grade, participation and cancers arising between scheduled screens when evaluating repeated screening programmes. They also suggest that uniform schedules may not maintain effectiveness equally across populations or settings.

What to keep in mind

The analysis included ERSPC centres except France, and detection trends varied by centre; the abstract does not provide quantitative estimates of the reported rates.