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Prostate specific antigen based biennial screening is sufficient to detect almost all prostate cancers while still
Jonas Hugosson1, Gunnar Aus, Hans Lilja
1Department of Urology, Sahlgrenska Universitetssjukhuset, Göteborg, Sweden.
The Journal of Urology
|April 11, 2003
Summary
Biennial prostate specific antigen (PSA) screening is sufficient for men with PSA levels below 2 ng/mL. Men with higher PSA levels or negative biopsies may benefit from shorter screening intervals for curable prostate cancer detection.
Area of Science:
- Urology
- Oncology
- Preventive Medicine
Background:
- Prostate cancer screening aims to detect the disease early for curable treatment.
- Prostate-specific antigen (PSA) testing is a common method for prostate cancer screening.
Purpose of the Study:
- To evaluate the sufficiency of biennial prostate specific antigen (PSA) screening alone for detecting curable prostate cancer.
Main Methods:
- A randomized study in Göteborg, Sweden, involving 9,972 men aged 50-65.
- Participants underwent PSA screening, with further tests (digital rectal examination, ultrasound, biopsies) for PSA levels of 3 ng/mL or higher.
Main Results:
- First screening: 5,854 participants, 145 cancers detected. Second screening: 5,267 participants, 111 cancers detected.
- Most cancers (92%) detected in the second screening had PSA levels below 10 ng/mL.
- Men with initial PSA < 1 ng/mL did not develop PSA > 3 ng/mL or interval cancer.
Conclusions:
- Biennial PSA-only screening appears safe for men with baseline PSA < 2 ng/mL.
- Men with PSA 2-3 ng/mL or elevated PSA with negative biopsy may require shorter screening intervals.
- Individualized screening intervals based on baseline PSA are suggested for optimal prostate cancer detection.