Intermediate-Term Risk of Prostate Cancer is Directly Related to Baseline Prostate Specific Antigen: Implications for Reducing the Burden of Prostate Specific Antigen Screening
2015; Lippincott Williams & Wilkins; Volume: 194; Issue: 1 Linguagem: Inglês
10.1016/j.juro.2015.02.043
ISSN1527-3792
AutoresJonathan Gelfond, Kara Choate, Donna P. Ankerst, Javier Hernández, Robin J. Leach, Ian M. Thompson,
Tópico(s)Hepatitis B Virus Studies
ResumoNo 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. 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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 ...
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