Prostate cancer screening and mortality: A case-control study (United States)

Objective: We performed a case-control study at Kaiser Permanente Northwest to assess the association between digital rectal examination (DRE) and prostate-specific antigen (PSA) testing, separately and together, and prostate cancer mortality. Methods: We identified 171 KPNW members who died as a result of prostate cancer from 1992 to 1999 and 342 randomly-selected KPNW members matched to the cases on age, sex, and length of plan membership. History of screening was determined from medical records and laboratory databases for cases and controls. Results: DRE and/or PSA screening at any time up to and including the case diagnosis date had taken place among 69.0% of cases and 74.6% of controls. After using logistic regression analysis to adjust for matching variables and a provider diagnosis of benign prostatic hypertrophy (BPH), we found an inverse association between receipt of a prostate cancer screening test and prostate cancer mortality (odds ratio (OR): 0.70, 95% confidence interval (CI): 0.46-1.1). Most of the screening tests were DREs, and it was not possible to assess the separate influence of PSA screening. Conclusions: The results of this study suggest that men who have been screened for prostate cancer have a reduced risk of dying as a result of this disease.