Updated Cochrane review: PSA screening likely lowers prostate cancer deaths by about two per 1,000

The edition in brief

An updated abridged Cochrane review of six randomised trials with 789,086 participants found that prostate cancer screening likely reduces prostate cancer-specific mortality (risk ratio 0.87, 95% CI 0.80 to 0.95 in the ERSPC sensitivity analysis, moderate certainty), about two fewer deaths per 1,000, and may slightly reduce all-cause mortality, though that interval includes no effect. Adverse event data were limited. A UK multicentre trial of 700 men on androgen deprivation therapy found that a supervised exercise and diet programme improved cancer-specific quality of life and fatigue at 12 months versus optimised usual care. A phase I trial of 25 patients found that alternating intravesical gemcitabine and BCG was well tolerated, with 24 achieving complete response at 6 months, which needs randomised confirmation. A meta-analysis of 62 trials found only moderate correlation of progression-free survival and response rate with overall survival in metastatic renal cell carcinoma.