Incidence trends of prostate cancer in East Anglia, before and during the era of PSA diagnostic testing

Pashayan, Nora; Powles, John; Brown, Charles; Duffy, Stephen W.

doi:10.1038/sj.bjc.6603247

Cited by 11 publications

(6 citation statements)

References 11 publications

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“…The relatively small percentage of prostate cancer cases, 5.6% (38 out of 680), between 1996 and 2002 with a recorded prediagnosis or peridiagnosis PSA test is surprising. However, the estimated number of excess cases (252) in East Anglia based on the results here is very close to the number estimated (289) based on age-period-cohort analysis reported in our previous study (Pashayan et al, 2006). There may be minor faults in record linkage between the cancer registry and the laboratory records for PSA testing and subsequent underestimation in the estimates of excess diagnosis associated with PSA testing.…”

Section: Discussionsupporting

confidence: 84%

“…A descriptive epidemiological study in East Anglia has shown a 6% excess of prostate cancer registrations during 1991 -2000 relative to expectations based on pre-1991 trends, coincident with an increase in prostate-specific antigen (PSA) testing (Pashayan et al, 2006). This increase in PSA testing came not from a formal screening programme (no such programme existed), but rather from the increased use of the test for case finding and in the investigation of men with urological symptoms.…”

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confidence: 99%

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Excess cases of prostate cancer and estimated overdiagnosis associated with PSA testing in East Anglia

Pashayan¹,

Powles²,

Brown

et al. 2006

Br J Cancer

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This study aimed to estimate the extent of 'overdiagnosis' of prostate cancer attributable to prostate-specific antigen (PSA) testing in the Cambridge area between 1996 and 2002. Overdiagnosis was defined conceptually as detection of prostate cancer through PSA testing that otherwise would not have been diagnosed within the patient's lifetime. Records of PSA tests in Addenbrookes Hospital were linked to prostate cancer registrations by NHS number. Differences in prostate cancer registration rates between those receiving and not receiving prediagnosis PSA tests were calculated. The proportion of men aged 40 years or over with a prediagnosis PSA test increased from 1.4 to 5.2% from 1996 to 2002. The rate of diagnosis of prostate cancer was 45% higher (rate ratios (RR) ¼ 1.45, 95% confidence intervals (CI) 1.02 -2.07) in men with a history of prediagnosis PSA testing. Assuming average lead times of 5 to 10 years, 40 -64% of the PSA-detected cases were estimated to be overdiagnosed. In East Anglia, from 1996 to 2000, a 1.6% excess of cases was associated with PSA testing (around a quarter of the 5.3% excess incidence cases observed in East Anglia from 1996 to 2000). Further quantification of the overdiagnosis will result from continued surveillance and from linkage of incidence to testing in other hospitals.

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Section: Discussionsupporting

confidence: 84%

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confidence: 99%

Excess cases of prostate cancer and estimated overdiagnosis associated with PSA testing in East Anglia

Pashayan¹,

Powles²,

Brown

et al. 2006

Br J Cancer

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“…Indeed, prostate cancer accounts for over a quarter of all cancers in men and the risk increases with age (1). There has been an increase in the reported incidence of prostate cancer since the early 1980's, most likely due to an increased use of screening using the PSA test (31) although the effectiveness of screening for prostate cancer remains controversial (32). …”

Section: Discussionmentioning

confidence: 99%

Small Integrin-Binding Proteins as Serum Markers for Prostate Cancer Detection

Jain

McKnight

Fisher

et al. 2009

Clinical Cancer Research

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Purpose: The small integrin-binding ligand N-linked glycoprotein (SIBLING) gene family includes bone sialoprotein (BSP), dentin matrix protein 1 (DMP1), dentin sialophosphoprotein (DSPP), matrix extracellular phosphoglycoprotein (MEPE), and osteopontin (OPN). Previous studies have separately reported elevated expression of BSP, OPN, or DSPP in prostate tumor paraffin sections. We hypothesized that SIBLINGs may be informative serum markers for subjects with prostate cancer. Methods: Expression levels of SIBLINGs in biopsies of normal tissue and tumors from prostate were determined by cDNA array and by immunohistochemical staining with monoclonal antibodies. Competitive ELISAs for measuring total BSP, DSPP, MEPE, and OPN were applied to a test group of 102 subjects with prostate cancer and 110 normal subjects and a validation group of 90 subjects. Results: BSP, DMP1, DSPP, and OPN exhibited elevated mRNA expression and protein levels in biopsies. BSP, DSPP, and OPN were elevated in serum from prostate cancer subjects, with serum DSPP exhibiting the greatest difference, yielding an area under the receiver operator characteristic curve value of 0.98. Serum BSP and OPN levels were significantly elevated only in late stages, whereas DSPP was significantly elevated at all stages. Optimal serum value cutoff points derived for BSP, OPN, and DSPP were applied as a validation test to a new group of 90 subjects and DSPP yielded a sensitivity of 90% and a specificity of 100%. Conclusion: Of the SIBLING gene family members, DSPP appears to be a strong candidate for use in serum assays for prostate cancer detection. (Clin Cancer Res 2009;15(16):5199-207)

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“…An argument against PSA testing explaining all of the increases in prostate cancer incidence is that the rates were already increasing in countries such as the USA and Aus- tralia prior to the introduction of PSA testing [48]. Moreover, increases have been observed in countries with a lower prevalence of PSA testing, such as Japan (Fig.…”

Section: Trendsmentioning

confidence: 97%

International epidemiology of prostate cancer: Geographical distribution and secular trends

Baade

Youlden

Krnjacki

2009

Molecular Nutrition Food Res

378

314

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This review outlines current international patterns in prostate cancer incidence and mortality rates and survival, including recent trends and a discussion of the possible impact of prostate-specific antigen (PSA) testing on the observed data. Internationally, prostate cancer is the second most common cancer diagnosed among men (behind lung cancer), and is the sixth most common cause of cancer death among men. Prostate cancer is particularly prevalent in developed countries such as the United States and the Scandinavian countries, with about a six-fold difference between high-incidence and low-incidence countries. Interpretation of trends in incidence and survival are complicated by the increasing impact of PSA testing, particularly in more developed countries. As Western influences become more pronounced in less developed countries, prostate cancer incidence rates in those countries are tending to increase, even though the prevalence of PSA testing is relatively low. Larger proportions of younger men are being diagnosed with prostate cancer and living longer following diagnosis of prostate cancer, which has many implications for health systems. Decreasing mortality rates are becoming widespread among more developed countries, although it is not clear whether this is due to earlier diagnosis (PSA testing), improved treatment, or some combination of these or other factors.

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Incidence trends of prostate cancer in East Anglia, before and during the era of PSA diagnostic testing

Cited by 11 publications

References 11 publications

Excess cases of prostate cancer and estimated overdiagnosis associated with PSA testing in East Anglia

Excess cases of prostate cancer and estimated overdiagnosis associated with PSA testing in East Anglia

Small Integrin-Binding Proteins as Serum Markers for Prostate Cancer Detection

International epidemiology of prostate cancer: Geographical distribution and secular trends

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