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Publication - Professor Athene Lane

    Latest results from the UK trials evaluating prostate cancer screening and treatment: The CAP and ProtecT studies


    Lane, J, Hamdy, F, Martin, R, Turner, E, Neal, D & Donovan, J, 2010, ‘Latest results from the UK trials evaluating prostate cancer screening and treatment: The CAP and ProtecT studies’. European Journal of Cancer, vol 46., pp. 3095 - 3101


    The European Randomised Study of Screening for Prostate Cancer (ERSPC) demonstrated a
    significant reduction in prostate cancer-specific mortality. The ongoing Comparison Arm
    for ProtecT (CAP) cluster randomised controlled trial (RCT) evaluates prostate cancer
    screening effectiveness by comparing primary care centres allocated to a round of prostate
    specific antigen (PSA) testing (intervention) or standard clinical care. Over 550 centres
    (around 450,000 men) were randomised in eight United Kingdom areas (2002–2008). Intervention
    group participants were also eligible for the ProtecT (Prostate testing for cancer
    and Treatment) RCT evaluating active monitoring, radiotherapy and radical prostatectomy
    treatments for localised prostate cancer. In ProtecT, over 1500 of around 3000 men with
    prostate cancer were randomised from over 10,000 with an elevated PSA in around
    111,000 attendees at clinics. Investigation of the psychological impact of screening in a
    sub-sample showed that 10% of men still experienced high distress up to 3 months following
    prostate biopsies (22/227), although most were relatively unaffected. The risk of prostate
    cancer with a raised PSA was lower if urinary symptoms were present (frequent
    nocturia odds ratio (OR) 0.44, 95% confidence interval (CI) 0.22–0.83) or if a repeat PSA
    decreased by P20% prior to biopsy (OR 0.43, 95% CI 0.35–0.52). Men aged 45–49 years
    attended PSA clinics less frequently (442/1299, 34%) in a nested cohort with a cancer
    detection rate of 2.3% (10/442). The CAP and ProtecT trials (ISRCTN92187251 and
    ISRCTN20141217) will help resolve the prostate cancer screening debate, define the optimum
    treatment for localised disease and generate evidence to improve men’s health.

    Full details in the University publications repository