# ERSPC (European Randomized Study of Screening for Prostate Cancer)

Source: https://onco.cc/trials/erspc/  
OnCo record `erspc` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The trial that showed PSA screening does stop some men dying of prostate cancer, and showed at the same time how many men have to be tested, and how many treated for a cancer that was never going to harm them, to achieve it.

## Summary

ERSPC identified 182,000 men aged 50 to 74 through population registries in seven European countries in the early 1990s and randomised them to an offer of prostate-specific antigen screening, on average once every four years, or to a control group that was not offered it. The predefined core age group was 162,243 men aged 55 to 69. Eighty-two percent of the men offered screening accepted at least one round.

At a median of nine years the cumulative incidence of prostate cancer was 8.2 percent in the screened group against 4.8 percent in the control group, and the rate ratio for death from prostate cancer was 0.80. The absolute difference was 0.71 deaths per 1,000 men, which the authors expressed as 1,410 men needing to be screened and 48 additional cancers needing to be treated to prevent one death.

The 16-year report, on 182,160 men with a core group of 162,389, found the same rate ratio with a tighter interval and a larger absolute benefit: the absolute mortality difference grew from 0.14 percent at 13 years to 0.18 percent at 16, the number needed to invite fell from 742 to 570 and the number needed to diagnose from 26 to 18. Those two sets of figures use different denominators, men invited against men screened, which is the commonest way this trial is misquoted.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-25
- Also known as: ERSPC; European Randomized Study of Screening for Prostate Cancer; European Randomised Study of Screening for Prostate Cancer
- Registry id: ISRCTN49127736
- Phase: 3
- Setting: Population screening: men aged 50 to 74 identified from population registries and randomised to an offer of PSA screening about every four years or to no offer, with death from prostate cancer as the primary outcome in a predefined core age group of men aged 55 to 69
- Sponsor: Erasmus MC with the ERSPC collaborating centres in eight European countries
- Result: Rate ratio for prostate cancer death 0.80 (95 percent confidence interval 0.65 to 0.98, adjusted p=0.04) at a median of nine years, and 0.80 (0.72 to 0.89, p<0.001) at 16 years; 1,410 screened and 48 extra cancers treated per death prevented at nine years, 570 invited and 18 diagnosed at 16 years.
- Outcomes: Death from prostate cancer, core age group 55 to 69, median 9 years: Offered PSA screening 0.8 rate ratio; Death from prostate cancer, core age group, 16 years: Offered PSA screening 0.8 rate ratio; Cumulative incidence of prostate cancer, median 9 years: Offered PSA screening 8.2% vs Control 4.8%
- Replication: PLCO, running at the same time in the United States, found no mortality difference, but roughly half its control group was screened outside the trial, so the two trials compared organised screening with opportunistic screening rather than with none. CAP, the cluster-randomised trial of a single PSA invitation in UK general practice, found no mortality reduction at 15 years.

## Sources

- ERSPC at 9 years (New England Journal of Medicine 2009): https://doi.org/10.1056/NEJMoa0810084
- ERSPC at 16 years (European Urology 2019): https://doi.org/10.1016/j.eururo.2019.02.009
- ISRCTN registry ISRCTN49127736: https://www.isrctn.com/ISRCTN49127736

## Connected records

- cancers: [Localised prostate cancer, high and very high risk](https://onco.cc/cancers/prostate-high-risk/), [Localised prostate cancer, intermediate risk](https://onco.cc/cancers/prostate-intermediate-risk/), [Localised prostate cancer, very low and low risk](https://onco.cc/cancers/prostate-low-risk/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- terms: [Overdiagnosis](https://onco.cc/terms/overdiagnosis/), [PSA (prostate-specific antigen)](https://onco.cc/terms/psa/)
- trials: [GÖTEBORG-2 (MRI-based prostate cancer screening)](https://onco.cc/trials/goteborg-2/), [PLCO, prostate component (Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial)](https://onco.cc/trials/plco-prostate/), [ProtecT](https://onco.cc/trials/protect/)

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JSON: https://onco.cc/api/v1/entities/erspc.json