Key Programs
International Prostate Screening Trials Evaluation Group (IPSTEG)
Background Information
The International Prostate Screening Trial Evaluation Group (IPSTEG)
is a collaboration between the researchers in Europe and North America
conducting prostate cancer screening randomized trials. Countries
included in the collaboration are Belgium, Finland, Italy, Portugal,
Spain, Sweden, Switzerland, the Netherlands and the United States.
The purpose of this collaboration is to develop and implement an
evaluation plan for the joint analysis of randomized trial data on
prostate cancer screening using prostate specific antigen (PSA). A
combined analysis offers increased statistical power and a larger, more
informative database over an individual study. The total sample is
anticipated to be in excess of 300,000 men, with a follow-up period of
at least 10 years.
Common Areas and Variabilities
All trials adhere to a common core protocol with mortality from
prostate cancer as the primary endpoint. Some core elements are age at
recruitment between 55 and 67, collection of baseline characteristics,
exclusion of men with previous diagnosis of prostate cancer, individual
randomization, information on contamination levels, and evaluation of
cost effectiveness.
Although the trials have a common core protocol, variability exists
among the trials which will allow for important comparisons beyond the
protocol of any one trial. Some of these elements are variability in
PSA cut points, PSA screening with and without digital rectal
examination (DRE), different screening intervals (from one to four
years), and inclusion of men outside the core ages. This variability
will allow examination of sensitivity and specificity at various PSA
cut-offs, differences between screening frequencies and optimal age for
beginning and ending screening.
Information Exchange
The IPSTEG collaboration has resulted in a rich exchange of
information. IPSTEG meets annually in conjunction with the European
Randomized Study of Screening for Prostate Cancer (ERSPC) to monitor
the adherence of individual trials to the core protocol. In addition to
developing an evaluation plan, the group is also devising a publication
policy and protocols for pathology and death review. Individual trials
within IPSTEG are collecting and sharing information on health related
quality of life and cost effectiveness in relation to prostate cancer
screening.