Boost for Prostate Cancer Screening - Report Shows Mortality Reduction as High as 31%

Personal 'Risk Assessment' Reduces Unnecessary Biopsies by 33%, Confirms Latest ERSPC Findings

ROTTERDAM, The Netherlands, December 8 - The effectiveness of PSA (prostate-specific antigen) screening on
reducing prostate cancer mortality has been given a boost with new data from
the European Randomized Study of Screening for Prostate Cancer (ERSPC). This
shows the true impact to be far higher than previously reported - up to 31%.

Preliminary ERSPC findings* showed that screening reduced prostate cancer
deaths by 20%. This latest ERSPC analysis** corrects for non-attendance and
contamination to assess the effectiveness of PSA testing in those men
actually screened: www.erspc.org.com.

From 1992, the ERSPC study randomized 162,000 men, aged 55 to 69, in
seven European countries to either a screening arm or a control group. Those
screened were given a blood test to detect PSA levels: if it was 3.0ng/ml or
more, they were offered a biopsy. Screening took place on average every four
years. Mean follow-up was nine years.

In any randomized trial, some in the screening arm do not attend and some
in the control group inadvertently receive a PSA test (contamination).
Contamination makes it difficult to detect differences. This is believed to
be one reason why the Prostate Lung, Colon and Ovarian (PLCO) study failed to
detect any significant reduction in mortality.

PSA cut off level of 3ng/ml is safer threshold for reducing biopsies

Using retrospective data from the Dutch arm, the ERSPC has shown that
using a screening algorithm - an individual risk assessment - alongside PSA
testing can reduce the number of unnecessary biopsies. PSA testing is
sensitive but not specific, so elevated levels do not necessarily imply
cancer. Approximately 30% of detected cancers are non-aggressive - 'indolent'
or slow growing.

Their findings, published in January 2010's European Urology (already
online www.europeanurology.com/current-issue) suggest that a PSA cut
off level of 3ng/ml combined with an individual risk assessment would reduce
biopsies by 33%. The majority of cancers potentially missed would be
indolent, so there would be no benefit from active treatment. Increasing the
PSA cut-off level from 3 to 4 ng/ml may save a similar number of biopsies,
but will miss more clinically significant cancers.

*NEJM, March 2009

**European Urology, October 2009

Contact: Jennie Wilde: jennie at carverwilde.com, +44(0)20-3178-5563/4 +44(0)-7799-412230