M M Cookson1. 1. Department of Urologic Surgery, Vanderbilt University School of Medicine, A1302 Medical Center North, Nashville, TN 37232-2765, USA. michael.cookson@mcmail.vanderbilt.edu
Abstract
BACKGROUND: Despite more than a decade of prostate-specific antigen (PSA)-based screening, the proven impact of screening on mortality due to prostate cancer continues to be controversial. METHODS: A literature review of issues pertaining to the epidemiology, screening, early detection, and mortality as they relate to prostate cancer was conducted. Included in the review are PSA refinements, controversies of screening, and organization guidelines. Finally, recent reports of mortality rates in the post-PSA era are presented for discussion. RESULTS: Prostate cancer mortality rates have begun to decline for the first time since statistics have been recorded. The recent decline in age-adjusted mortality rates from prostate cancer is significant, and this decline appears to be earlier than would have been predicted. This finding, coupled with the dramatic decline in metastatic disease, implies that PSA-based screening may be responsible for a significant portion of this improvement in mortality. CONCLUSIONS: The cost of prostate cancer screening appears to be acceptable. Randomized studies of PSA-based screening are currently ongoing, although the results may not be available for a decade. Currently, the best evidence is derived from population-based studies that appear to show a benefit to prostate cancer screening.
BACKGROUND: Despite more than a decade of prostate-specific antigen (PSA)-based screening, the proven impact of screening on mortality due to prostate cancer continues to be controversial. METHODS: A literature review of issues pertaining to the epidemiology, screening, early detection, and mortality as they relate to prostate cancer was conducted. Included in the review are PSA refinements, controversies of screening, and organization guidelines. Finally, recent reports of mortality rates in the post-PSA era are presented for discussion. RESULTS:Prostate cancer mortality rates have begun to decline for the first time since statistics have been recorded. The recent decline in age-adjusted mortality rates from prostate cancer is significant, and this decline appears to be earlier than would have been predicted. This finding, coupled with the dramatic decline in metastatic disease, implies that PSA-based screening may be responsible for a significant portion of this improvement in mortality. CONCLUSIONS: The cost of prostate cancer screening appears to be acceptable. Randomized studies of PSA-based screening are currently ongoing, although the results may not be available for a decade. Currently, the best evidence is derived from population-based studies that appear to show a benefit to prostate cancer screening.
Authors: Giorgio Calleris; Giancarlo Marra; Ettore Dalmasso; Marco Falcone; Robert Jeffrey Karnes; Alessandro Morlacco; Marco Oderda; Rafael Sanchez-Salas; Francesco Soria; Paolo Gontero Journal: World J Urol Date: 2019-04-06 Impact factor: 4.226
Authors: Alixanna M Norris; Michael Gentry; Donna M Peehl; Ralph D'Agostino; Karin D Scarpinato Journal: Cancer Epidemiol Biomarkers Prev Date: 2009-01 Impact factor: 4.254
Authors: Belal M Azab; Rupesh Dash; Swadesh K Das; Sujit K Bhutia; Siddik Sarkar; Xue-Ning Shen; Bridget A Quinn; Paul Dent; Igor P Dmitriev; Xiang-Yang Wang; David T Curiel; Maurizio Pellecchia; John C Reed; Devanand Sarkar; Paul B Fisher Journal: J Cell Physiol Date: 2014-01 Impact factor: 6.384