Twenty-Three-Year Follow-Up on European Randomized Study of Prostate Cancer Screening

This long-term analysis of over 160,000 European men examined whether PSA-based screening for prostate cancer effectively reduces mortality over 23 years.

After a median follow-up of 23 years, PSA screening reduced prostate cancer mortality by 13% compared to no screening, with an absolute risk reduction of 0.22%. However, screening increased the overall incidence of prostate cancer diagnoses. For every 456 men invited to screening, one prostate cancer death was prevented. Among those diagnosed, one death was prevented for every 12 men. These figures reflect an improvement in the balance between the benefits and harms of screening, compared to the earlier 16-year analysis.

Overall, long-term findings confirm that PSA screening provides a sustained reduction in prostate cancer deaths, though it increases diagnoses. The authors strongly advocate for future risk-based screening strategies that minimize overdiagnosis while maintaining significant mortality benefits.

New England Journal of Medicine 2025;393: 17