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Screening for prostate cancer using serum prostate-specific antigen: a randomised, population-based pilot study in
A Auvinen1, T Tammela, U H Stenman
1Finnish Centre for Radiation and Nuclear Safety, Helsinki, Finland.
British Journal of Cancer
|August 1, 1996
Summary
This study shows that population-based prostate cancer screening using prostate-specific antigen (PSA) testing is feasible in Finland. The PSA test demonstrated suitable properties for a randomized screening study, detecting cancers effectively.
Area of Science:
- Urology
- Public Health
- Oncology
Background:
- Prostate cancer screening using serum prostate-specific antigen (PSA) is under discussion.
- Previous studies often relied on self-selected volunteers, limiting generalizability.
- Assessing feasibility in a population-based registry is crucial for wider implementation.
Purpose of the Study:
- To evaluate the feasibility of a prostate cancer screening study using a population registry.
- To determine the participation rate and cancer detection rate in a randomized sample.
- To assess the utility of free to total PSA ratio in improving screening accuracy.
Main Methods:
- A random sample of 600 men aged 55, 60, and 65 was selected from the Finnish Population Registry.
- 300 men were invited to participate; 230 (77%) accepted.
- Serum PSA levels were measured, with abnormal results prompting further diagnostic tests.
Main Results:
- Six prostate cancer cases were detected among 230 participants (2.6% detection rate).
- The positive predictive value for PSA was 24%.
- Using the free to total PSA ratio reduced false positives from 8% to 3% while missing one cancer.
Conclusions:
- Population-based prostate cancer screening is feasible in Finland.
- Serum PSA testing shows suitable properties for a randomized screening study.
- Further multicenter studies are warranted based on these findings.