Sci-Bytes> Hot Paper in Medicine
Week of February 20, 2011
"Screening and prostate-cancer mortality in a randomized European study," by Fritz H. Schröder and 23 others, New England Journal of Medicine, 360(13): 1320-8, 26 March 2009.
[Authors' affiliations: 15 European institutions]
Abstract: "Background The European
Randomized Study of Screening for Prostate Cancer was initiated in the
early 1990s to evaluate the effect of screening with
prostate-specific-antigen (PSA) testing on death rates from prostate
cancer. Methods We identified 182,000 men between the ages
of 50 and 74 years through registries in seven European countries for
inclusion in our study. The men were randomly assigned to a group that was
offered PSA screening at an average of once every 4 years or to a control
group that did not receive such screening. The predefined core age group
for this study included 162,243 men between the ages of 55 and 69 years.
The primary outcome was the rate of death from prostate cancer. Mortality
follow-up was identical for the two study groups and ended on December 31,
2006. Results In the screening group, 82% of men accepted
at least one offer of screening. During a median follow-up of 9 years, the
cumulative incidence of prostate cancer was 8.2% in the screening group and
4.8% in the control group. The rate ratio for death from prostate cancer in
the screening group, as compared with the control group, was 0.80 (95%
confidence interval [CI], 0.65 to 0.98; adjusted P = 0.04). The absolute
risk difference was 0.71 death per 1000 men. This means that 1410 men would
need to be screened and 48 additional cases of prostate cancer would need
to be treated to prevent one death from prostate cancer. The analysis of
men who were actually screened during the first round (excluding subjects
with noncompliance) provided a rate ratio for death from prostate cancer of
0.73 (95% CI, 0.56 to 0.90). Conclusions PSA-based
screening reduced the rate of death from prostate cancer by 20% but was
associated with a high risk of overdiagnosis."
This 2009 report from the New England Journal of Medicine was
cited 59 times in current journal articles indexed by
Clarivate during
September-October 2010. As was the case after the previous count covering
July-August, this report currently scores as the second-most-cited medicine
published in the last two years, aside from reviews. Prior to the most
recent two-month tally, citations to the paper have accrued as
follows:
July-August 2010: 53 citations
May-June 2010: 58
March-April 2010: 49
January-February 2010: 52
November-December 2010: 42
September-October 2010: 43
July-August 2010: 38
May-June 2010: 10
March-April 2010: 2
Total citations to date: 406
SOURCE: Hot Papers Database (Included with a subscription to the print newsletter Science Watch®, available from the Research Services Group of Thomson Reuters. Packaged on a CD that is mailed with each Science Watch issue, the Hot Papers Database contains data on hundreds of highly cited papers published during the last two years. User interface permits searching by author, organization, journal, field, and more. Total citations, as well as citations accrued during successive bimonthly periods, can be assessed and graphed.
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