Lindberg A, Talala K, Kujala P, Stenman U-H, Taari K, Kilpeläinen TP, Tammela T, Auvinen A. Bias-corrected estimates of PSA screening decisions on the risk of prostate cancer diagnosis and death: Analysis of the Finnish Randomized Study of Screening for Prostate Cancer. Int J Cancer Jan 2019 doi:10.1002/ijc.32129
We used a counterfactual exclusion method on the data of the FinRSPC to adjust for the effects of screening non-compliance and PSA contamination on risk of PC incidence and PC death at 15 years of follow-up. After correcting for non-compliance and contamination, PSA screening led to 32.4 (95% CI 26.4, 38.6) more PC diagnoses per 1,000 men and 1.4 (95% CI 0.0, 2.8) fewer PC deaths compared to the control arm. These results can be used for patient counselling in informed decision-making about PC screening. Because the previous studies have mainly concentrated on the population-level effects of screening, our study offers new and topical results relevant for clinical practice.
Kukko V, Kaipia A, Talala K, Taari K, Tammela TLJ, Auvinen A, Murtola TJ. Allopurinol and risk of prostate cancer in a Finnish population-based cohort. Prostate Cancer and Prostatic Diseases 2019 Jan 29. doi: 10.1038/s41391-019-0129-2.
We studied the association between allopurinol use and prostate cancer (PCa) incidence. The cohort consists of 76,874 men without prevalent PCa, originally identified for the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC). We used Cox regression (adjusted for age, FinRSPC trial arm, PCa family history and use of other medication) to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of PCa risk by allopurinol use. There were 9,062 new PCa diagnoses in the cohort. The risk of PCa did not differ by allopurinol use (multivariable adjusted HR 1.03; 95% CI 0.92-1.16).