Clinical, pathological, and therapeutic features of newly diagnosed prostate cancer predominantly detected by opportunistic PSA screening: A survey of Shiga Prefecture, Japan

Abstract

BackgroundIn all the prefectures of Japan, with the exception of Shiga Prefecture, more than half of local governments have an organized prostate‐specific antigen (PSA) screening system in place. However, in the Shiga Prefecture, only a single city performed PSA screening over the time period of this survey. The purpose of the present study was to determine the clinical, pathological, and therapeutic features of newly diagnosed prostate cancer in localities where a formally organized screening system was almost entirely absent.MethodsA multicenter observational study was conducted in the Shiga Prefecture, which has the lowest rate of population‐based PSA‐screening in Japan. Patients' age, initial PSA, reasons for PSA testing, Gleason score, clinical stage, and primary treatments were surveyed. We stratified patients according to the reasons for PSA measurement, and compared the differences between groups subject to organized versus opportunistic screening.ResultsIn the 2 years 2012 and 2017, 984 newly diagnosed prostate cancer patients were analyzed. Of these, 954 (97%) were opportunistically tested (i.e., not as part of an organized screening system), with the remaining 29 (3%) measured as part of an organized screening program. Patients in the former group exhibited a higher initial PSA value than in the organized screening group (median: 11.49 vs. 5.67 ng/ml). They also had worse clinical features, including higher Gleason score and TNM stage. More patients in the organized screening group were treated curatively than in the nonorganized screening group in terms of the primary treatment. The results were similar in a subanalysis of the patients of age 50–69 years.ConclusionsOrganized PSA screening contributes to increasing the number of patients diagnosed with early‐stage cancer who can be treated curatively.

Vim-PSA Double-Target DBS for the Treatment of Holmes Tremor Secondary to Brainstem Hemorrhage: A Case Report

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Prevalence and temporal trends of prostate diseases among inpatients with cardiovascular disease: a nationwide real-world database survey in Japan

“…In addition, we found a modestly increasing temporal trend of prevalent prostate diseases in the cohort examined, consistent with the global trend of increased burden of prostate diseases in general populations ( 1 – 5 ). This increase may reflect aging and indicate the need to promote public and clinical awareness of prostate diseases ( 3 , 42 ) and PCa screening with prostate-specific antigen tests ( 43 – 45 ). Collectively, continued surveillance is needed to further clarify the clinical characteristics of prostate diseases among patients with CVD.…”

Population‑based prostate‑specific antigen screening for prostate cancer may have an indirect effect on early detection through opportunistic testing in Kusatsu City, Shiga, Japan

“…As a multicenter observational study, this investigation was conducted in 14 hospitals in Shiga Prefecture, Japan, as previously reported ( 8 ). Briefly, in 2012 and 2017, patients diagnosed with prostate cancer were surveyed.…”

“…Features of newly-diagnosed patients with prostate cancer in Shiga Prefecture were previously reported. A total of 97% of the patients were discovered through opportunistic PSA testing and showed worse clinical features than those patients diagnosed via an organized population-based screening ( 8 ). In the present study, a subanalysis was conducted to compare the characteristics of patients diagnosed with prostate cancer in 2012 and 2017 in Kusatsu City (Japan), the only municipality in Shiga Prefecture that implemented an organized population-based PSA screening, with those of patients in other municipalities in the prefecture.…”