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Related Experiment Videos

Prostate-specific antigen-based serial screening may decrease prostate cancer-specific mortality.

Jason A Efstathiou1, Ming-Hui Chen, William J Catalona

  • 1Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, Massachusetts 02115, USA. jefstathiou@partners.org

Urology
|August 15, 2006
PubMed
Summary
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Men diagnosed with prostate cancer via screening had slower PSA recurrence and lower cancer mortality compared to community referrals. Screening detects less aggressive prostate cancer, improving outcomes.

Area of Science:

  • Urology
  • Oncology
  • Public Health

Background:

  • Prostate-specific antigen (PSA) screening has evolved as a tool for early prostate cancer detection.
  • Understanding the long-term outcomes of screen-detected versus community-referred prostate cancer is crucial for clinical management.
  • Prostate cancer-specific mortality (PCSM) and PSA doubling time (DT) are key indicators of disease aggressiveness.

Purpose of the Study:

  • To compare preoperative characteristics, postoperative PSA doubling time (DT), and PCSM estimates after PSA failure.
  • To evaluate differences between men diagnosed via a screening study versus a community referral population.
  • To assess the impact of screening on prostate cancer recurrence and mortality.

Main Methods:

  • A cohort of 1492 men with localized prostate cancer who underwent radical prostatectomy and experienced PSA failure was analyzed.

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  • Patients were categorized into two groups: those from a screening study (n=841) and those from community practices (n=611).
  • Statistical comparisons of PSA levels, Gleason scores, tumor stage, PSA-DT, and PCSM estimates were performed.

    • Main Results:

    • Screened men had lower PSA at diagnosis (5.1 vs 9.5 ng/mL), less high-grade cancer (25.1% vs 42.1%), and more low-risk disease (64.5% vs 23.8%) compared to community referrals.
    • The screened cohort showed a significant reduction in shorter PSA-DT (<12 months) and an increase in longer PSA-DT (≥12 months).
    • Ten-year PCSM estimates were substantially lower in the screened cohort (3.6%) versus the community cohort (11.3%).

    Conclusions:

    • Annual prostate cancer screening appears to identify men with more indolent disease.
    • Patients diagnosed through screening demonstrate a lower likelihood of dying from prostate cancer after PSA recurrence.
    • Screening may lead to better long-term prognoses for prostate cancer patients.