HighlightsPowerful analysis of a national cohort’s 362 methadone-specific deaths.Scottish cohort of 33,128 methadone-prescription clients in 2009–2013.Steeper age-gradient than for all drugs-related deaths.No gender differential in the hazard of methadone-specific deaths.Increased hazard at the highest quintile for quantity of methadone prescribed.

ALM and PD contributed equally to the work.incident cases aged 50-69 years (agerestricted Cancer Registry cases) registered with the Eastern Cancer Registration and Information Centre (ECRIC). RESULTSWithin ProtecT, 94 427 men agreed to be tested (50% of men contacted), 8807 ( ≈ 9%) had a raised PSA level and 2022 (23%) had prostate cancer; 229 ( ≈ 12%) had locally advanced (T3 or T4) or metastatic cancers, the rest having clinically localized (T1c or T2) disease. Within ECRIC, 12 661 cancers were recorded over the same period; 3714 were men aged 50-69 years at diagnosis. Men in ProtecT had a lower age distribution and PSA level, and the cancers were of lower stage and grade ( P < 0.001 for all comparisons). If population-based PSA testing were introduced in the UK, ≈ 2660 men per 100 000 aged 50-69 years would be found to have prostate cancer, compared to current rates of ≈ 130 per 100 000. If half of men accepted PSA testing, ≈ 160 000 cancers would be found, compared to 30 000 diagnosed each year at present. CONCLUSIONSPopulation-based PSA testing resulted in a significant downward stage and grade migration, and most such cancers were of low stage and grade, which could lead to risks of over-treatment for some men.