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1995; BMJ; Volume: 310; Issue: 6987 Linguagem: Inglês

10.1136/bmj.310.6987.1140b

0959-8138

Christopher Hyde,

Meta-analysis and systematic reviews

Thus most cancers detected were aggressive, and only a small number of men with prostate specific antigen concentrations >4 0 ng/ml would have a diagnosis of a non-aggressive cancer preceded by a long disease free interval.This was also true for the subset of men who were aged under 70 when the diagnosis was made.Compared with men with antigen concentrations of < 1 0 ng/ml, those with concentrations of 2-0-3-0 ng/ml had a relative risk of all prostate cancer of 5-5 and a relative risk of aggressive cancer of 6-8.It is important to note that this was a once only test, and the potential benefit of repeat screening or the addition of other screening modalities was not available.For men older than 70 watchful waiting may be appropriate management.This new study shows, however, that in this population of American doctors the mean age at diagnosis of prostate cancer was 68-7 years, most of the cancers detected were aggressive, and three quarters of deaths in the cases were directly related to the diagnosis.Thus in younger men screening for prostate specific antigens may be justified, particularly for those in higher risk groups, such as those with a family history ofprostate cancer.45