Prediction of significant prostate cancer diagnosed 20 to 30 years later with a single measure of prostate-specific antigen at or before age 50 Journal Article
| Authors: | Lilja, H.; Cronin, A. M.; Dahlin, A.; Manjer, J.; Nilsson, P. M.; Eastham, J. A.; Bjartell, A. S.; Scardino, P. T.; Ulmert, D.; Vickers, A. J. |
| Article Title: | Prediction of significant prostate cancer diagnosed 20 to 30 years later with a single measure of prostate-specific antigen at or before age 50 |
| Abstract: | BACKGROUND: We previously reported that a single prostate-specific antigen (PSA) measured at ages 44-50 was highly predictive of subsequent prostate cancer diagnosis in an unscreened population. Here we report an additional 7 years of follow-up. This provides replication using an independent data set and allows estimates of the association between early PSA and subsequent advanced cancer (clinical stage ≥T3 or metastases at diagnosis). METHODS: Blood was collected from 21,277 men in a Swedish city (74% participation rate) during 1974-1986 at ages 33-50. Through 2006, prostate cancer was diagnosed in 1408 participants; we measured PSA in archived plasma for 1312 of these cases (93%) and for 3728 controls. RESULTS: At a median follow-up of 23 years, baseline PSA was strongly associated with subsequent prostate cancer (area under the curve, 0.72; 95% CI, 0.70-0.74; for advanced cancer, 0.75; 95% CI, 0.72-0.78). Associations between PSA and prostate cancer were virtually identical for the initial and replication data sets, with 81% of advanced cases (95% CI, 77%-86%) found in men with PSA above the median (0.63 ng/mL at ages 44-50). CONCLUSIONS: A single PSA at or before age 50 predicts advanced prostate cancer diagnosed up to 30 years later. Use of early PSA to stratify risk would allow a large group of low-risk men to be screened less often but increase frequency of testing on a more limited number of high-risk men. This is likely to improve the ratio of benefit to harm for screening. © 2010 American Cancer Society. |
| Keywords: | adult; controlled study; middle aged; unclassified drug; major clinical study; case-control studies; advanced cancer; cancer staging; follow up; follow-up studies; cancer diagnosis; neoplasm staging; prostate specific antigen; blood chemical analysis; disease association; metastasis; risk factors; cancer screening; age factors; prediction; risk assessment; prostate cancer; sweden; prostate-specific antigen; prostatic neoplasms; antigen detection; carcinoma; kallikrein; high risk population; early detection of cancer; kallikrein related peptidase 2; predictive value; human kallikrein 2; case-control study |
| Journal Title: | Cancer |
| Volume: | 117 |
| Issue: | 6 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2011-03-15 |
| Start Page: | 1210 |
| End Page: | 1219 |
| Language: | English |
| DOI: | 10.1002/cncr.25568 |
| PUBMED: | 20960520 |
| PROVIDER: | scopus |
| PMCID: | PMC3412541 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 23 June 2011" - "CODEN: CANCA" - "Source: Scopus" |
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