Increasing age among men screened for prostate cancer may predict a greater likelihood of being diagnosed with clinically significant tumors, according to a recent study.
In a study of 7625 men who participated in the Göteborg-1 prostate cancer screening trial, the risk of being diagnosed with Gleason score 3+4 or higher cancer compared with lower-grade cancer rose 11% with each 1-year increase in age, Rebecka Arnsrud Godtman, MD, of the Institute of Clinical Science in Gothenburg, Sweden, and colleagues reported in European Urology.
The association between higher-grade prostate cancer and age should be considered when counseling men regarding early diagnosis and treatment for the cancer, Dr Godtman’s team concluded.
Many guidelines recommend against PSA screening in men older than 70 to 75 years because of the risk of overdiagnosis and lack of evidence of a mortality reduction in this age group, the authors pointed out. From a population perspective, the harms of screening might outweigh the benefits in an older population, they noted. From an individual’s perspective, however, stopping PSA testing for all men at age 70 years “is probably too early,” according to the investigators.
“From a clinical perspective, our findings of an increased risk of clinically significant [prostate cancer] with age question the optimal age of stopping screening and early detection of [prostate cancer],” the investigators wrote.
Of the 7625 men in the study, 1022 were diagnosed with prostate cancer. Their median age at diagnosis was 65 years.
Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Godtman RA, Kollberg KS, Pihl CG, Månsson M, Hugosson J. The association between age, prostate cancer risk, and higher Gleason score in a long-term screening program: Results from the Göteborg-1 prostate cancer screening trial. Eur Urol. Published online February 1, 2022. doi:10.1016/.eururo.2022.01.018