This study basically folds in 2 additional years' worth of data, bringing the total study time to 11 years (or ~ 1.8 million man-years, in a sense). I think yo

This study basically folds in 2 additional years' worth of data, bringing the total study time to 11 years (or ~ 1.8 million man-years, in a sense). I think your summary of the impact is a good one re: all-cause mortality. It is curious, however, that there was a relative reduction in deaths from prostate cancer in the screened group. It turns out that the way randomization was done differed across countries. Detection of what procedures were done differed across groups. Treatment also differed across groups: for those randomized to screening, treatment was at major academic centers, suggesting that they may have had better care. I would think that this would make it more likely to cause a false rejection of the null hypothesis re: all-cause mortality, so I don't think it calls into question that part of the study. But it does trigger some concerns re: study design. A related editorial in the NEJM raises some of the points, too.