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October 14, 2009

Prostate Cancer Screening and Surveillance

JAMA. 2009;302(14):1529-1530. doi:10.1001/jama.2009.1438

To the Editor: In their Clinical Crossroads article, Drs Sanda and Kaplan1 reviewed prostate cancer treatment. I am concerned about some of their statements regarding the findings of the European Randomized Study of Screening for Prostate Cancer (ERSPC).2 First, they described the reduction in prostate cancer mortality by noting 326 deaths among controls vs 214 in the screened group. However, this was misleading because it did not indicate that the control group had 89 435 participants while the screened group had only 72 952. Although there was, nonetheless, a real benefit (with a rate ratio of 0.80 at 9 years), the absolute risk reduction was only 0.71 per 1000 men, which I believe gives a different but more accurate impression.

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