Baseline prostate-specific antigen measurements and subsequent prostate cancer risk in the Danish Diet, Cancer and Health cohort Journal Article


Authors: Larsen, S. B.; Brasso, K.; Iversen, P.; Christensen, J.; Christiansen, M.; Carlsson, S.; Lilja, H.; Friis, Sø; Tjønneland, A.; Dalton, S. O.
Article Title: Baseline prostate-specific antigen measurements and subsequent prostate cancer risk in the Danish Diet, Cancer and Health cohort
Abstract: Aim Although prostate-specific antigen (PSA) screening reduces mortality from prostate cancer, substantial over-diagnosis and subsequent overtreatment are concerns. Early screening of men for PSA may serve to stratify the male population by risk of future clinical prostate cancer. Methods and material Case-control study nested within the Danish 'Diet, Cancer and Health' cohort of 27,179 men aged 50-64 at enrolment. PSA measured in serum collected at cohort entry in 1993-1997 was used to evaluate prostate cancer risk diagnosed up to 14 years after. We identified 911 prostate cancer cases in the Danish Cancer Registry through 31st December 2007 1:1 age-matched with cancer-free controls. Aggressive cancer was defined as ≥T3 or Gleason score ≥7 or N1 or M1. Statistical analyses were based on conditional logistic regression with age as underlying time axis. Results Total PSA and free-to-total PSA ratio at baseline were strongly associated with prostate cancer risk up to 14 years later. PSA was grouped in quintiles and free-to-total PSA ratio divided in three risk groups. The incidence rate ratio for prostate cancer was 150 (95% confidence interval, 72-310) among men with a total PSA in the highest quintile (>5.1 ng/ml) compared to the lowest (<0.80 ng/ml). The risk of aggressive cancer was highly elevated in men with a PSA level in the highest quintile. The results indicate that one-time measurement of PSA could be used in an individualised screening strategy, sparing a large proportion of men from further PSA-based screening. © 2013 Elsevier Ltd. All rights reserved.
Keywords: adult; controlled study; aged; middle aged; major clinical study; case control study; case-control studies; cancer risk; cancer diagnosis; cancer incidence; prostate specific antigen; cohort studies; logistic models; incidence; risk factors; mass screening; risk factor; prostate cancer; gleason score; prostate-specific antigen; prostatic neoplasms; diet; cancer registry; denmark; prostate neoplasm; baseline; nested case-control study
Journal Title: European Journal of Cancer
Volume: 49
Issue: 14
ISSN: 0959-8049
Publisher: Elsevier Inc.  
Date Published: 2013-09-01
Start Page: 3041
End Page: 3048
Language: English
DOI: 10.1016/j.ejca.2013.04.015
PROVIDER: scopus
PUBMED: 23684783
PMCID: PMC4074899
DOI/URL:
Notes: --- - "Export Date: 1 October 2013" - "CODEN: EJCAE" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Hans Gosta Lilja
    286 Lilja