Fifteen year follow-up of CAP trial of association between PSA screening and prostate cancer mortality

The Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP) in England and Wales found no effect of a single invitation for PSA screening in men aged 50 to 69 years on prostate cancer mortality at a median 10-year follow-up (primary outcome), but long-term effects of PSA screening on prostate cancer mortality remain unclear. Results of the study at median 15-year follow-up have now been published. In this secondary analysis of a trial of 415,357 men randomized to a single invitation for PSA screening (n=195,912) or a control group without PSA screening (n=219,445) and followed-up for a median of 15 years, risk of death from prostate cancer was lower in the group invited to screening compared with the control group (0.69% versus 0.78%). The authors conclude that compared with no invitation for routine PSA testing, a single invitation for a PSA screening test reduced prostate cancer mortality at a median follow-up of 15 years, but the absolute mortality benefit was small.