OBJECTIVE: To study the use of a baseline prostate-specific antigen (PSA) and digital rectal examination in men (aged 40-49 years) in predicting long-term prostate cancer risk in a prospectively followed, representative population cohort. PATIENTS AND METHODS: Since 1990, a random sample of men in Olmsted County (aged 40-49 years) has been followed up prospectively (n = 268), with biennial visits, including a urologic questionnaire, PSA screening, and physical examination. The ensuing risk of prostate cancer (CaP) was compared using survival analyses. RESULTS: Median follow-up was 16.3 years (interquartile range 14.0-17.3, max 19.1). For men with a baseline PSA <1.0 ng/mL (n = 195), the risk of subsequent Gleason 6 CaP diagnosis by 55 years was 0.6% (95% confidence interval [CI] 0%-1.7%) and 15.7% (95% CI 6.5%-24.9%) for men with a baseline PSA ≥ 1.0 ng/mL. No man with a low baseline PSA developed an intermediate or high risk CaP, whereas 2.6% of men with a higher baseline PSA did (95% CI 0.58%-4.6%). CONCLUSION: Men (aged 40-49 years) can be stratified with a baseline PSA. If it is below 1.0 ng/mL, there is very little risk for developing a lethal CaP, and as many as 75% of men might be able to avoid additional PSA screening until 55 years. Conversely, men aged 40-49 years with a baseline PSA level >1.0 ng/mL had a significant risk of CaP diagnosis and should be monitored more closely.
OBJECTIVE: To study the use of a baseline prostate-specific antigen (PSA) and digital rectal examination in men (aged 40-49 years) in predicting long-term prostate cancer risk in a prospectively followed, representative population cohort. PATIENTS AND METHODS: Since 1990, a random sample of men in Olmsted County (aged 40-49 years) has been followed up prospectively (n = 268), with biennial visits, including a urologic questionnaire, PSA screening, and physical examination. The ensuing risk of prostate cancer (CaP) was compared using survival analyses. RESULTS: Median follow-up was 16.3 years (interquartile range 14.0-17.3, max 19.1). For men with a baseline PSA <1.0 ng/mL (n = 195), the risk of subsequent Gleason 6 CaP diagnosis by 55 years was 0.6% (95% confidence interval [CI] 0%-1.7%) and 15.7% (95% CI 6.5%-24.9%) for men with a baseline PSA ≥ 1.0 ng/mL. No man with a low baseline PSA developed an intermediate or high risk CaP, whereas 2.6% of men with a higher baseline PSA did (95% CI 0.58%-4.6%). CONCLUSION:Men (aged 40-49 years) can be stratified with a baseline PSA. If it is below 1.0 ng/mL, there is very little risk for developing a lethal CaP, and as many as 75% of men might be able to avoid additional PSA screening until 55 years. Conversely, men aged 40-49 years with a baseline PSA level >1.0 ng/mL had a significant risk of CaP diagnosis and should be monitored more closely.
Authors: Timothy J Wilt; Michael K Brawer; Karen M Jones; Michael J Barry; William J Aronson; Steven Fox; Jeffrey R Gingrich; John T Wei; Patricia Gilhooly; B Mayer Grob; Imad Nsouli; Padmini Iyer; Ruben Cartagena; Glenn Snider; Claus Roehrborn; Roohollah Sharifi; William Blank; Parikshit Pandya; Gerald L Andriole; Daniel Culkin; Thomas Wheeler Journal: N Engl J Med Date: 2012-07-19 Impact factor: 91.245
Authors: Hans Lilja; David Ulmert; Thomas Björk; Charlotte Becker; Angel M Serio; Jan-Ake Nilsson; Per-Anders Abrahamsson; Andrew J Vickers; Göran Berglund Journal: J Clin Oncol Date: 2007-02-01 Impact factor: 44.544
Authors: Stacy Loeb; Kimberly A Roehl; Jo Ann V Antenor; William J Catalona; Brian K Suarez; Robert B Nadler Journal: Urology Date: 2006-01-25 Impact factor: 2.649
Authors: David Ulmert; Angel M Cronin; Thomas Björk; Matthew F O'Brien; Peter T Scardino; James A Eastham; Charlotte Becker; Göran Berglund; Andrew J Vickers; Hans Lilja Journal: BMC Med Date: 2008-02-15 Impact factor: 8.775
Authors: Vincenzo Mirone; Ciro Imbimbo; Davide Arcaniolo; Marco Franco; Roberto La Rocca; Luca Venturino; Lorenzo Spirito; Massimiliano Creta; Paolo Verze Journal: World J Urol Date: 2017-08-05 Impact factor: 4.226