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• W1981611851 abstract "No AccessJournal of UrologyAdult Urology1 Jul 2015Intermediate-Term Risk of Prostate Cancer is Directly Related to Baseline Prostate Specific Antigen: Implications for Reducing the Burden of Prostate Specific Antigen Screening Jonathan Gelfond, Kara Choate, Donna P. Ankerst, Javier Hernandez, Robin J. Leach, and Ian M. Thompson Jonathan GelfondJonathan Gelfond Department of Biostatistics and Epidemiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas More articles by this author , Kara ChoateKara Choate Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas More articles by this author , Donna P. AnkerstDonna P. Ankerst Department of Biostatistics and Epidemiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas More articles by this author , Javier HernandezJavier Hernandez Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas More articles by this author , Robin J. LeachRobin J. Leach Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Cellular and Structural Biology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas More articles by this author , and Ian M. ThompsonIan M. Thompson Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas Financial interest and/or other relationship with Magforce and Exosome Diagnostics. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.043AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Prostate specific antigen screening is controversial, as a large number of men must be screened annually to achieve a benefit. We sought to determine whether baseline prostate specific antigen could reliably predict subsequent risk of prostate cancer and risk of consequential prostate cancer. Materials and Methods: A multiethnic cohort of 2,923 prostate cancer-free men was recruited between 2000 and 2012, and followed for a median of 7.5 years. Baseline prostate specific antigen was stratified into 6 strata and relative hazards of prostate cancer detection for each prostate specific antigen stratum were estimated, adjusting for ethnicity, family history and age. Results: During followup 289 patients were diagnosed with prostate cancer. Men with baseline prostate specific antigen in the lowest stratum (0.1 to 1.0 ng/ml) were at greatly reduced risk for prostate cancer during followup. This half of the cohort with prostate specific antigen 1.0 ng/ml or less were at 3.4% (95% CI 2.1, 4.5) 10-year risk of prostate cancer and 90% of the cancers were low risk. By comparison the other half were at 15% to 39% risk of cancer detection with a 39% risk in the highest stratum (3 to 10 ng/ml). Conclusions: Optimal prostate specific antigen screening frequency for men with a prostate specific antigen level of 0.1 to 1.0 ng/ml may be up to every 10 years. This approach has the potential to dramatically reduce the cost of screening, decreasing over detection of inconsequential tumors, while maintaining detection of tumors for which treatment has been proven to reduce prostate cancer mortality. References 1 : Cancer statistics, 2014. CA Cancer J Clin2014; 64: 9. Google Scholar 2 : Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet2014; 384: 2027. Google Scholar 3 : Yearly prostate specific antigen and digital rectal examination fluctuations in a screened population. J Urol2009; 181: 2071. Link, Google Scholar 4 : Operating characteristics of prostate-specific antigen in men with an initial PSA level of 3.0 ng/ml or lower. JAMA2005; 294: 66. Google Scholar 5 : Mortality results from a randomized prostate-cancer screening trial. N Engl J Med2009; 360: 1310. Google Scholar 6 : Cumulative incidence of false-positive results in repeated, multimodal cancer screening. Ann Fam Med2009; 7: 212. Google Scholar 7 : Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med2012; 157: 120. Google Scholar 8 : Early detection of prostate cancer: AUA Guideline. J Urol2013; 190: 419. Link, Google Scholar 9 : The cost implications of prostate cancer screening in the Medicare population. Cancer2014; 120: 96. Google Scholar 10 : Long-term prediction of prostate cancer up to 25 years before diagnosis of prostate cancer using prostate kallikreins measured at age 44 to 50 years. J Clin Oncol2007; 25: 431. Google Scholar 11 : Baseline prostate-specific antigen testing at a young age. Eur Urol2012; 61: 1. Google Scholar 12 : Prostate specific antigen concentration at age 60 and death or metastasis from prostate cancer: case-control study. BMJ2010; 341: c4521. Google Scholar 13 : Influence of blood prostate specific antigen levels at age 60 on benefits and harms of prostate cancer screening: population based cohort study. BMJ2014; 348: g2296. Google Scholar 14 : The distribution of serum prostate-specific antigen levels among American men: implications for prostate cancer prevalence and screening. Prostate2006; 66: 1044. Google Scholar 15 : Against quantiles: categorization of continuous variables in epidemiologic research, and its discontents. BMC2012; 12: 21. Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 194Issue 1July 2015Page: 46-51Supplementary Materials Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordsmass screeningprostate-specific antigenprognosisprostatic neoplasmsriskMetricsAuthor Information Jonathan Gelfond Department of Biostatistics and Epidemiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas More articles by this author Kara Choate Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas More articles by this author Donna P. Ankerst Department of Biostatistics and Epidemiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas More articles by this author Javier Hernandez Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas More articles by this author Robin J. Leach Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Cellular and Structural Biology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas More articles by this author Ian M. Thompson Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas Department of Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas Financial interest and/or other relationship with Magforce and Exosome Diagnostics. More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W1981611851 title "Intermediate-Term Risk of Prostate Cancer is Directly Related to Baseline Prostate Specific Antigen: Implications for Reducing the Burden of Prostate Specific Antigen Screening" @default.
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• W1981611851 doi "https://doi.org/10.1016/j.juro.2015.02.043" @default.
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