Impact of race and baseline PSA on longitudinal PSA

Abstract

There is an increasing debate regarding the frequency of prostatespecific antigen (PSA) testing and the current primary screening modality used to detect prostate cancer. The purpose of this study is to determine whether PSA screening intervals should be based on initial PSA. Our study explores longitudinal changes of PSA levels in black and white males separately. Study participants were 768 white and 450 black males attending an annual prostate cancer screening. We fit a longitudinal repeated measures model separately for blacks and whites and estimated the probability of PSA converting to greater than 4.0 ng/ml at a follow-up year given baseline PSA range among males without an abnormal DRE. Black and white males with a baseline PSA between 0 and 1.0 ng/ml, with a healthy or enlarged prostate, have a less than 1% chance that their PSA will increase above 4.0 ng/ml over the following 5 years. Black and white males with a PSA between 1.0 and 1.9 ng/ml have a less than 1% chance of PSA conversion to greater than 4.0 ng/ml over the next year. Our findings further support that annual screening for prostate cancer may not be necessary, specifically males with a baseline PSA less than 2.0 may not need to undergo annual screening. Our results suggest that race does not affect the longitudinal trend of PSA enough to warrant setting screening intervals based on race. ' 2005 Wiley-Liss, Inc.

P085 Preventing unnecessary invasive cancer-diagnostic tests

“…The present study suggests that the appropriate cut-off point for tPSA of Iranian men is 7.85 ng/ml, slightly different from those in other countries (9,10). In USA and Europe, men with a tPSA of <2.5 ng/ml have a low probability of having clinically detected prostate cancer (11,12).…”

A longitudinal study of PSA and its influential factors in a cohort of Chinese men with initial PSA levels less than 4 ng ml−1

“…16,17 Some studies have suggested that men with an initial PSA level ,1 ng ml 21 have a 99% probability of PSA levels remaining normal (,4 ng ml 21 ) for the next 4 or 5 years. 15 In our study, men with an initial PSA level ,1 ng ml 21 had only a 1.88% chance of having PSA levels .4 ng ml 21 and a 2.89% chance of having PSA levels .3 ng ml 21 in the next 4 years. A previous study performed a population-based screening of Japanese men to determine the optimal screening interval for men with PSA levels ,2.0 ng ml 21 .…”

“…Similar results were observed in a previous study that evaluated the influence of baseline PSA on longitudinal PSA in black and white patients. 15 In that study, black and white men with a PSA between 3.0 and 3.9 ng ml 21 had a 44.7% and 51.6% chance, respectively, of converting to PSA .4.0 ng ml 21 in the following 4 years. The percentage in our study was even higher.…”

Counseling the Patient with Prostate Cancer: 2016 Update

“…Prostate cancer is the most common cancer in American men [1][2][3][4][5][6][7][8][9][10][11][12]. The ever-expanding, seemingly conflicting literature on prostate cancer makes counseling patients with prostate cancer a difficult but often necessary part of clinical practice.…”

“…As a pathological entity, prostate cancer occurs in almost all men as same report the risk of long term urinary incontinence is 14.4% for the radical surgery group and 4.9% for the radiotherapy group. Patients choosing radiotherapy should understand that the risk of uncomfortable bowel urgency and painful hemorrhoids are more prevalent with radiation than surgery [2]. The authors reminded us that in patients who choose radiation over surgery, performing radical prostatectomy after failure of radiotherapy is difficult and associated with more complications.…”