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Longitudinal screening for prostate cancer with prostate-specific antigen
D S Smith1, W J Catalona, J D Herschman
1Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
JAMA
|October 23, 1996
Summary
Serial prostate-specific antigen (PSA) screening showed decreasing abnormal results and cancer detection rates over four years. This approach shifted detection towards earlier-stage, lower-grade prostate cancers in older men.
Area of Science:
- Urology
- Oncology
- Public Health
Background:
- Prostate cancer screening using prostate-specific antigen (PSA) is a widely discussed topic.
- Understanding trends in compliance, detection rates, and cancer characteristics is crucial for evaluating screening programs.
Purpose of the Study:
- To analyze the initial four-year trends of serial PSA-based screening.
- To assess compliance, abnormal test result prevalence, cancer detection rates, and the stage/grade of detected cancers.
Main Methods:
- A community-based study involving serial PSA measurements for prostate cancer screening.
- 10,248 male volunteers aged 50+ were screened every six months for at least 48 months.
Main Results:
- Screening compliance remained high, with 79% returning at 48 months.
- A decrease was observed in elevated PSA levels (4.0 ng/mL), cancer detection rates, and clinically advanced cancers.
- A reduction in high-grade and pathologically advanced cancers was noted among surgically treated men.
Conclusions:
- Serial PSA screening led to fewer abnormal results and a cancer detection rate approaching population incidence.
- Screening facilitated the detection of cancers at earlier clinical stages and lower grades.
- Further cost-benefit analyses are needed to determine the economic impact of these shifts in detection.