Screening-Detected PCa May Be Less Risky
These tumors are more likely to be organ confined at the time of surgery.
In addition, a separate study by researchers in
The mean age of both groups was 60 years. The investigators analyzed preoperative total PSA levels, age, pathological characteristics, and prostate volume, finding that screen-detected cancers were significantly more likely to be organ confined at the time of surgery.
“This is the first study to look at this,” lead investigator Alexandre Pelzer, MD, assistant professor of urology at the Medical University of Innsbruck. “The principal goal is to decrease mortality, and we do decrease mortality by about 50% in Tyrol compared to the rest of
For the past several years, the Tyrol PSA Screening Project has produced data supporting the use of PSA screening in men age 50 and older. The new data show that screening results in patients being picked up with lower grade disease and lower risk of having positive margins.
In a separate study presented at the meeting, researchers in
The median delay from baseline PSA screening to diagnosis was 17 years. Plasma levels of all PSA forms were strongly associated with case status. Even a small elevation in total PSA levels markedly increased risk. The risk of advanced prostate cancer by age 75 was 2% for men with a total PSA level of 0.5 ng/mL.
There was a direct increase in risk with each higher level. The risk increased to 3% for men with a total PSA level of 0.75 ng/mL; 4% for a level of total PSA of 1.0 ng/mL; 7% for men with a total PSA of 1.5 ng/mL; and 12% risk (three times the population mean) for men with a total PSA of 2.0 ng/mL at age 44-50.
The researchers concluded that screening and chemoprevention trial efforts could be risk-stratified if men were screened between the ages of 44 and 50. Study investigator Hans Lilja, MD, PhD, who presented the findings here at the American Urological Association annual meeting, said that this approach could lead to more frequent monitoring of those found at baseline to have elevated risk.
Ultimately, this could help reduce prostate cancer morbidity and mortality rates. In this study, risk was highly concentrated, with 60% of the advanced cancers occurring in men in the top 20% of PSA levels in this population of men aged 50 years, and younger at the time when blood was drawn at baseline.