***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: INTRODUCTION Mass screening modalities remained controversial and made necessary large studies . The European R and omized study of Screening for Prostate cancer ( ERSPC ) was initiated in 1994 . Eight countries including France are participating . METHODS ERSPC is a multicentric r and omised study and started with the aim to determine whether a 20 % reduction in prostate cancer mortality can be achieved with PSA-based screening .  Men aged 50 - 74 and living in the Tarn or Hérault were included . After r and omization and exclusion of men who died or had a prostate cancer were invited to participate by giving their consent and had a PSA test . In case of PSA greater than or equal to 3 ng/ml , biopsy was recommended . Included men in both screening and control group were followed through cancer registries . Objective was to present first round results of French participation to ERSPC , to determine factors of participation and to compare detected cancers cases between both groups . RESULTS Population of men included was 84,781 and were r and omized in screening ( n=42,590 ) or control ( n=42,191 ) group .  Participation rate was 36.9 % in Tarn and 24.3 % in Hérault . PSA was greater than or equal to 3 ng/ml in 15,4 % of cases ( n=1812 ) and 45.9 % of men ( n=832 ) who were biopsied . Age , previous PSA performed within two years prior to invitation , health insurance and department of residence were significantly associated to participation rate . Cumulated incidence with a four years follow-up was 2.48 % ( n=1053 ) in screening and 1.99 % ( n=840 ) in control group , with a relative risk ( RR ) of 1.242 . Corresponding RR for Tarn and Hérault were 1.37 and 1.20 respectively . Clinical parameters and treatments modalities were similar between both screening and control groups ( radical prostatectomy 68 % and radiation therapy 20 % ) . CONCLUSION Participation rate at first round was modest . Profile of men who participated compared to men who did not were different . The control group was probably contaminated by PSA testing outside study protocol . Consequences at ERSPC level of this low participation rate on final analysis remain to be determined Substantial progress has been made since 1979 when the Canadian Task Force on the Periodic Health Examination set about generating ‘ statements of evidence ’ for ranking the validity of evidence about the effectiveness of preventative measures 14 . And , although their goal was to provide a way of rating the strength and quality of studies and link these to ‘ grade s of recommendations ’ , these ratings were based to a large extent on the type of study design with the r and omised controlled trial as the highest level . Significantly , these grade s of recommendation did not consider uncertainty around the results nor did they incorporate explicit judgements , such as for example the weighting of tradeoffs between harms and benefits , and how these might correlate with the strength of recommendations The objectives of the Prostate , Lung , Colorectal and Ovarian Cancer Screening Trial are to determine in screenees ages 55 - 74 at entry whether screening with flexible sigmoidoscopy ( 60-cm sigmoidoscope ) can reduce mortality from colorectal cancer , whether screening with chest X-ray can reduce mortality from lung cancer , whether screening men with digital rectal examination ( DRE ) plus serum prostate-specific antigen ( PSA ) can reduce mortality from prostate cancer , and whether screening women with CA125 and transvaginal ultrasound ( TVU ) can reduce mortality from ovarian cancer . Secondary objectives are to assess screening variables other than mortality for each of the interventions including sensitivity , specificity , and positive predictive value ; to assess incidence , stage , and survival of cancer cases ; and to investigate biologic and /or prognostic characterizations of tumor tissue and biochemical products as intermediate endpoints . The design is a multicenter , two-armed , r and omized trial with 37,000 females and 37,000 males in each of the two arms . In the intervention arm , the  PSA and CA125 tests  are performed at entry , then annually for 5 years . The  DRE , TVU , and chest X-ray exams  are performed at entry and then annually for 3 years . Sigmoidoscopy is performed at entry and then at the 5-year point . Participants in the control arm follow their usual medical care practice s. Participants will be followed for at least 13 years from r and omization to ascertain all cancers of the prostate , lung , colorectum , and ovary , as well as deaths from all causes . A pilot phase was undertaken to assess the r and omization , screening , and data collection procedures of the trial and to estimate design parameters such as compliance and contamination levels . This paper describes eligibility , consent , and other design features of the trial , r and omization and screening procedures , and an outline of the follow-up procedures . Sample -size calculations are reported , and a data analysis plan is presented Background There are a number of sound justifications for publishing nearly identical information in Chinese and English medical journals , assuming several conditions are met . Although overlap publication is perceived as undesirable and ethically question able in Europe and North America , it may serve an important function in some regions where English is not the native tongue . There is no empirical data on the nature and degree of overlap publication in English and Chinese language journals . Methods /Principal Findings A r and om sample of 100 English manuscripts from Chinese institutions was selected from PubMed . Key words and institutions were search ed in the China National Knowledge Infrastructure , a comprehensive Chinese language research data base . Unacknowledged overlap was a priori defined according to International Committee of Medical Journal Editor ( ICMJE ) guidelines following examination by two individuals . 19 % ( 95 % CI 11–27 ) of English manuscripts from Chinese institutions were found to have substantial overlap with Chinese published work based on full text examination . None of the manuscripts met all of the criteria established by the ICMJE for an acknowledged overlap publication . Individual-level , journal-level , and institutional factors seem to influence overlap publication . Manuscripts associated with an institution outside of China and with more than one institution were significantly less likely to have substantial overlap ( p<0.05 ) . Conclusions / Significance Overlap publication was common in this context , but instances of st and ard ICMJE notations to acknowledge this practice were rare . This research did not cite the identified overlap manuscripts with the hope that these empirical data will inform journal policy changes and structural initiatives to promote clearer policies and manuscripts BACKGROUND Epidemiologic studies have suggested that vitamin E and beta-carotene may each influence the development of prostate cancer . In the Alpha-Tocopherol , Beta-Carotene Cancer Prevention Study , a controlled trial , we studied the effect of alpha-tocopherol ( a form of vitamin E ) and beta-carotene supplementation , separately or together , on prostate cancer in male smokers . METHODS A total of 29133 male smokers aged 50 - 69 years from southwestern Finl and were r and omly assigned to receive alpha-tocopherol ( 50 mg ) , beta-carotene ( 20 mg ) , both agents , or placebo daily for 5 - 8 years ( median , 6.1 years ) . The supplementation effects were estimated by a proportional hazards model , and two-sided P values were calculated . RESULTS We found 246 new cases of and 62 deaths from prostate cancer during the follow-up period . A 32 % decrease ( 95 % confidence interval [ CI ] = -47 % to -12 % ) in the incidence of prostate cancer was observed among the subjects receiving alpha-tocopherol ( n = 14564 ) compared with those not receiving it ( n = 14569 ) . The reduction was evident in clinical prostate cancer but not in latent cancer . Mortality from prostate cancer was 41 % lower ( 95 % CI = -65 % to -1 % ) among men receiving  alpha-tocopherol .  Among subjects receiving beta-carotene ( n = 14560 ) , prostate cancer incidence was 23 % higher ( 95 % CI = -4%-59 % ) and mortality was 15 % higher ( 95 % CI = -30%-89 % ) compared with those not receiving it ( n = 14573 ) . Neither agent had any effect on the time interval between diagnosis and death . CONCLUSIONS Long-term supplementation with alpha-tocopherol substantially reduced prostate cancer incidence and mortality in male smokers . Other controlled trials are required to confirm the findings CONTEXT Secondary analyses of 2 r and omized controlled trials and supportive epidemiologic and pre clinical data indicated the potential of selenium and vitamin E for preventing prostate cancer . OBJECTIVE To determine whether selenium , vitamin E , or both could prevent prostate cancer and other diseases with little or no toxicity in relatively healthy men . DESIGN , SETTING , AND PARTICIPANTS A r and omized , placebo-controlled trial ( Selenium and Vitamin E Cancer Prevention Trial [ SELECT ] ) of 35,533 men from 427 participating sites in the United States , Canada , and Puerto Rico r and omly assigned to 4 groups ( selenium , vitamin E , selenium + vitamin E , and placebo ) in a double-blind fashion between August 22 , 2001 , and June 24 , 2004 . Baseline eligibility included age 50 years or older ( African American men ) or 55 years or older ( all other men ) , a serum prostate-specific antigen level of 4 ng/mL or less , and a digital rectal examination not suspicious for prostate cancer . INTERVENTIONS Oral selenium ( 200 microg/d from L-selenomethionine ) and matched vitamin E placebo , vitamin E ( 400 IU/d of all rac-alpha-tocopheryl acetate ) and matched selenium placebo , selenium + vitamin E , or placebo + placebo for a planned follow-up of minimum of 7 years and a maximum of 12 years . MAIN OUTCOME MEASURES Prostate cancer and prespecified secondary outcomes , including lung , colorectal , and overall primary cancer . RESULTS As of October 23 , 2008 , median overall follow-up was 5.46 years ( range , 4.17 - 7.33 years ) . Hazard ratios ( 99 % confidence intervals [ CIs ] ) for prostate cancer were 1.13 ( 99 % CI , 0.95 - 1.35 ; n = 473 ) for vitamin E , 1.04 ( 99 % CI , 0.87 - 1.24 ; n = 432 ) for selenium , and 1.05 ( 99 % CI , 0.88 - 1.25 ; n = 437 ) for selenium + vitamin E vs 1.00 ( n = 416 ) for placebo . There were no significant differences ( all P>.15 ) in any other prespecified cancer end points . There were statistically nonsignificant increased risks of prostate cancer in the vitamin E group ( P = .06 ) and type 2 diabetes mellitus in the selenium group ( relative risk , 1.07 ; 99 % CI , 0.94 - 1.22 ; P = .16 ) but not in the selenium + vitamin E group . CONCLUSION Selenium or vitamin E , alone or in combination at the doses and formulations used , did not prevent prostate cancer in this population of relatively healthy men . TRIAL REGISTRATION clinical trials.gov identifier : NCT00006392 BACKGROUND Prostate cancer is one of the leading causes of death from malignant disease among men in the developed world . One strategy to decrease the risk of death from this disease is screening with prostate-specific antigen ( PSA ) ; however , the extent of benefit and harm with such screening is under continuous debate . METHODS In December , 1994 , 20,000 men born between 1930 and 1944 , r and omly sample d from the population register , were r and omised by computer in a 1:1 ratio to either a screening group invited for PSA testing every 2 years ( n=10,000 ) or to a control group not invited ( n=10,000 ) . Men in the screening group were invited up to the upper age limit ( median 69 , range 67 - 71 years ) and only men with raised PSA concentrations were offered additional tests such as digital rectal examination and prostate biopsies . The primary endpoint was prostate-cancer specific mortality , analysed according to the intention-to-screen principle . The study is ongoing , with men who have not reached the upper age limit invited for PSA testing . This is the first planned report on cumulative prostate-cancer incidence and mortality calculated up to Dec 31 , 2008 . This study is registered as an International St and ard R and omised Controlled Trial IS RCT N54449243 . FINDINGS In each group , 48 men were excluded from the analysis because of death or emigration before the r and omisation date , or prevalent prostate cancer . In men r and omised to screening , 7578 ( 76 % ) of 9952 attended at least once . During a median follow-up of 14 years , 1138 men in the screening group and 718 in the control group  were diagnosed with prostate cancer , result ing in a cumulative prostate-cancer incidence of 12.7 % in the screening group and 8.2 % in the  control  group ( hazard ratio 1.64 ; 95 % CI 1.50 - 1.80 ; p<0.0001 ) . The absolute cumulative risk reduction of death from prostate cancer at 14 years was 0.40 % ( 95 % CI  
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None of the panels had been evaluated in routine clinical setting s. CONCLUSIONS The evidence on currently available SNP panels does not permit meaningful assessment of analytic validity .
The limited evidence on clinical validity is insufficient to conclude that the panels assessed would perform adequately as screening or risk stratification tests .
No evidence is available on the clinical utility of current panels