Prostate Cancer Screening in Tyrol, Austria: Experience and Results

Horninger, Wolfgang; Reissigl, Andreas; Rogatsch, Hermann; Volgger, Hubert; Studen, M.; Klocker, Helmut; Bartsch, Georg

doi:10.1159/000019893

Cited by 52 publications

(49 citation statements)

References 24 publications

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“…If an age-specific reference PSA level is used, then the positive predictive value rises to 64% if both are abnormal. 3,4 There is a high incidence of other associated tests in the present survey, which reflects the fact that 80% of PSA tests are done in the context of men who have presented with lower urinary tract symptoms or, much less frequently, are having a PSA checked within a group of other blood tests. Interestingly, given that a urinary tract infection can induce a PSA rise, only one in six GPs perform either an MSSU or urinary dipstick test.…”

Section: Discussionmentioning

confidence: 84%

“…12 The lower age limit is less well defined, but is usually 45 to 50 y. 3,11,12 Men with a family history of prostate cancer have a higher risk of prostate cancer, and this is reflected in the high percentage of GPs in our study who PSA test men who have a relative with prostate cancer. 13 The frequency with which screening is performed was not formally assessed in our study.…”

Section: Discussionmentioning

confidence: 91%

“…This is analogous to a previous study analysing PSA testing in general practice, which found that the frequency of PSA testing does not change significantly between age groups between 60 and 80 y old. 10 Although several screening studies regard age 75 as their upper age limit 3,11 , most suggest an upper age limit of 70 y. 12 The lower age limit is less well defined, but is usually 45 to 50 y.…”

Section: Discussionmentioning

confidence: 99%

“…Our study also showed that 9.3% of screened PSA tests were above 4.0 ng/ml, which is similar to previously reported studies, where 8-20% may be greater than 4.0 ng/ml, leading to a 1.2-3% cancer detection rate. 3,12,[15][16][17][18] An alternative to using a rigid PSA value to define an abnormality is to use age-referenced 12 Additional information can be obtained by the free to total PSA ratio. If the total PSA is less than 10 ng/ml, then 94% of cancers will exhibit a free to total ratio of 18% or less, and 42% of negative biopsies would be eliminated.…”

Section: Discussionmentioning

confidence: 99%

“…If the total PSA is less than 10 ng/ml, then 94% of cancers will exhibit a free to total ratio of 18% or less, and 42% of negative biopsies would be eliminated. 3 A prospective study by the same group recommended a slightly higher cutoff value of 22%, which detected 98% of cancers, and reduced the negative biopsy rate by 30%. 3 However, for screening purposes, free to total PSA ratio is not sufficient in itself to act as a screening test without the use of total PSA.…”

Section: Discussionmentioning

confidence: 99%

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PSA testing in general practice

Little

Gormley

et al. 2003

Prostate Cancer Prostatic Dis

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A questionnaire was sent to 400 general practitioners (GPs), concerning prostatespecific antigen (PSA) screening. Regarding the indications for PSA testing, 80% of GPs test men with urinary tract symptoms, 65% test men with a positive family history, 62% test on patient request, and 21% test men with unrelated symptoms. When PSA is measured, 91% of GPs inform their patient, and 71% discuss the significance of an abnormal result. The mean age range for PSA testing was from 50 years, without an upper age limit. The mode PSA threshold for referral was 6.6 ng/ml. De facto PSA screening appears to be widely practised.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

PSA testing in general practice

Little

Gormley

et al. 2003

Prostate Cancer Prostatic Dis

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The problem of cutoff levels in a screened population

Horninger¹,

Bartsch²,

Snow³

et al. 2001

Cancer

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Improvements in pathologic staging for African-American men undergoing radical retropubic prostatectomy during the prostate specific antigen era

Paquette¹,

Connelly²,

Sesterhenn

et al. 2001

Cancer

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BACKGROUND The objective was to compare the changes in pathologic and clinical data over time for African‐American (AA) and white men with prostate carcinoma undergoing radical prostatectomy in an attempt to determine the early impact of prostate specific antigen (PSA). METHODS Data from 195 AA and 587 white men who underwent radical prostatectomy from 1988 to 1999 in an equal access, tertiary, military medical facility were collected. Statistical analysis was used to determine the significance of the changes in the rates of extracapsular extension (ECE), positive margins, pretreatment PSA levels, and age at the time of surgery for each race over time. RESULTS Comparing 1988–99 results, the authors found that the percentage of AA men with ECE decreased from 100% to 34.8% (P = 0.007), and for white men from 56.9% to 43.2% (P = 0.269). The percentage of AA men with positive margins decreased from 100% to 26.1% (P < 0.0001), and for white men from 41.2% to 27.0% (P = 0.021). Mean age at surgery decreased from 66.6 to 59.9 years for AA men (P < 0.001) and from 65.9 to 61.1 years for white men (P < 0.001). Also, PSA levels decreased from 10.1 to 6.6 ng/dL for white men (P < 0.001) and from 16.5 to 6.5 ng/dL for AA men (P < 0.001). CONCLUSIONS The authors believe that the decrease in ECE and positive margins in AA men is primarily because of PSA testing, coupled with improved public awareness and equal access to care. It appears reasonable to recommend PSA testing in AA men, who have historically experienced poor outcomes from prostate carcinoma. Cancer 2001;92:2673–9. © 2001 American Cancer Society.

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Prostate Cancer Screening in Tyrol, Austria: Experience and Results

Cited by 52 publications

References 24 publications

PSA testing in general practice

PSA testing in general practice

The problem of cutoff levels in a screened population

Improvements in pathologic staging for African-American men undergoing radical retropubic prostatectomy during the prostate specific antigen era

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