Clinical outcomes of prostate cancer patients detected by prostate‐specific antigen‐based population screening in Kanazawa City, Japan

Abstract

Objectives: Most common population screening systems for prostate cancer are administered by municipal governments in Japan. These systems suffer from difficulties in adequate follow up of patients at several urology departments in the region. We analyzed the clinical characteristics and outcomes of prostate cancer patients detected in our prostatespecific antigen (PSA)-based population screen, and examined the efficiency of the system. Methods: Since 2000, we have carried out PSA-based population screening in men aged 55-69 years. For the present study, primary treatments and clinical outcomes of prostate cancer patients diagnosed by this screening program were obtained from each urology department in the region. Results: A total of 32 769 men participated in this screening program from 2000 to 2006. Overall, 249 cases (0.76%) of prostate cancer were diagnosed. The rate of patients within gray zone levels of serum total PSA on primary screening increased and this was significantly higher in 2003 than in the first 2 years of the program. Clinical T stage was defined in 247 patients (99.2%), and 231 (93.5%) were cases of clinically localized cancer. A total of 75% of these patients underwent radical treatment. Eight-year cause-specific and overall survivals were 97.5% and 93.3%, respectively. Four patients, all of them presenting with advanced disease at diagnosis, died from prostate cancer. Conclusions:The present study showed good clinical outcomes for screening-detected prostate cancer patients and it showed the effectiveness of our screening system.

Cumulative risk of developing prostate cancer in men with low (≤2.0 ng/mL) prostate‐specific antigen levels: A population‐based screening cohort study in Japan

“…Since 2000, PSA‐based screening has been provided for men aged between 55 and 69 years in Kanazawa city, Japan . All participants had serum total PSA levels measured using a Tosoh II PA kit (Tosoh, Tokyo, Japan) as a primary screening modality.…”

“…From 2000 to 2002, participants with serum PSA levels above 2.0 ng/mL were recommended to proceed to secondary screening by urologists. After 2003, participants with serum PSA above 10.0 ng/mL and those with serum free/total PSA ratio of 0.22 or lower in the PSA range of 2.1–10.0 ng/mL were recommended to proceed to secondary screening …”

Cumulative Probability of Prostate Cancer Detection Using the International Prostate Symptom Score in a Prostate-specific Antigen-based Population Screening Program in Japan

“…Since 2000, PSA-based annual population screening for prostate cancer has been provided for men aged 54-69 years in Kanazawa City, Japan (Kobori et al, 2008;Kitagawa et al, 2011). Serum total PSA (tPSA) levels were measured in all participants using a Tosoh II PA kit (Tosoh Corporation, Tokyo, Japan) as the primary screening modality, and all participants were asked to complete the IPSS questionnaire as an interview sheet for LUTS at the time of PSA testing.…”

“…From 2000 to 2002, participants with serum tPSA levels>2.0ng/mL were recommended to proceed to further examination by urologists at primary medical care clinics. After 2003, participants with serum tPSA>10.0 ng/mL and those with an f/t PSA ratio of ≤0.22 within the PSA reflex range of 2.1-10.0ng/mL were recommended to proceed to closer examination (Kobori et al, 2008;Kitagawa et al, 2011). Since 2012, the age range of participants has increased to 54-75 years.…”

“…exposure to PSA testing; several studies have already suggested that these systems may be effective for the early detection of prostate cancer (Kubota et al, 2002;Okihara et al, 2008;Kitagawa et al, 2011).…”