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Original Research

Open Access

Research of the best screen interval for middle aged and elderly Chinese males with baseline prostate specific antigen levels <2.0 ng/mL in prostate cancer screening

  • Yu Chen1
  • Gansheng Xie2,*,
  • Gang Li2
  • Yu Li2

1Department of Geriatrics, The First Affiliated Hospital of Soochow University, 215006 Suzhou, Jiangsu, China

2Department of Urology, The First Affiliated Hospital of Soochow University, 215031 Suzhou, Jiangsu, China

DOI: 10.22514/jomh.2024.159 Vol.20,Issue 9,September 2024 pp.146-150

Submitted: 04 July 2024 Accepted: 22 August 2024

Published: 30 September 2024

*Corresponding Author(s): Gansheng Xie E-mail: liyufyy@suda.edu.cn

Abstract

This study aimed to investigate the optimal screening interval of a prostate specific antigen (PSA) screening program for men aged 40–70 with a baseline PSA <2 ng/mL in China. 8-year period clinical data of Chinese males who underwent physical examination annually in our hospital were retrospectively collected. 397 healthy males were included.Total PSA (tPSA) and free PSA (fPSA) were collected, and the free/total PSA ratio (f/t PSA) was calculated. According to the baseline PSA value, study population was divided into 2 groups: 0–0.99 ng/mL and 1–1.99 ng/mL. Prostate biopsy indicates at tPSA >10 ng/mL, or 4–10 ng/mL (gray area) and f/t PSA <0.16. Kaplan-Meier survival analysis was used to calculate the relevant cumulative incidence rate. Over the eight-year screening period, 27 people (6.8%) had abnormal PSA that met prostate biopsy criteria. 7 cases of prostate cancer were detected (detection rate 25.9%) among the 27 patients who performed a biopsy. In the 0–0.99 ng/mL and 1–1.99 ng/mL group, 4.1% (13/317) and 17.5% (14/80) achieved biopsy criteria within 8 years, with a statistically significant difference (p < 0.001). In both groups, abnormal PSA began appearing in the sixth year. According to stratifying the cohort age and PSA, abnormal PSA levels began to appear in all subgroups by the sixth year, except for men aged <50 years plus baseline PSA <1 ng/mL, where they appeared by the seventh year. Furthermore, in the group of baseline 40–49 years and baseline PSA <2 ng/mL, the probability of meeting biopsy indications during eight years was very low (1.4%, 2/143). Chinese men aged 50–70 with baseline PSA <2 ng/mL should undergo for PSA retest in the sixth year, while aged 40–49 with a baseline PSA <2 ng/mL do not need PSA screening within eight years.


Keywords

Prostate specific antigen; Screening; Prostate cancer; Prostate biopsyProstate specific antigen; Screening; Prostate cancer; Prostate biopsy


Cite and Share

Yu Chen,Gansheng Xie,Gang Li,Yu Li. Research of the best screen interval for middle aged and elderly Chinese males with baseline prostate specific antigen levels <2.0 ng/mL in prostate cancer screening. Journal of Men's Health. 2024. 20(9);146-150.

References

[1] Carter HB, Albertsen PC, Barry MJ, Etzioni R, Freedland SJ, Greene KL, et al. Early detection of prostate cancer: AUA guideline. The Journal of Urology. 2013; 190: 419–426.

[2] Sawada K, Kitagawa Y, Ito K, Takeda Y, Mizokami A, Namiki M. Cumulative risk of developing prostate cancer in men with low (≤2.0 ng/mL) prostate‐specific antigen levels: a population‐based screening cohort study in Japan. International Journal of Urology. 2014; 21: 560–565.

[3] Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T, et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent—update 2013. European Urology. 2014; 65: 124–137.

[4] Cancer CfEotGoSfP, Association JU. Updated Japanese urological association guidelines on prostate‐specific antigen‐based screening for prostate cancer in 2010. International Journal of Urology. 2010; 17: 830–838.

[5] Randazzo M, Beatrice J, Huber A, Grobholz R, Manka L, Chun FK, et al. Is further screening of men with baseline PSA <1 ng ml−1 worthwhile? The discussion continues—results of the Swiss ERSPC (Aarau). International Journal of Cancer. 2015; 137: 553–559.

[6] Na R, Wu Y, Xu J, Jiang H, Ding Q. Age-specific prostate specific antigen cutoffs for guiding biopsy decision in Chinese population. PLOS ONE. 2013; 8: e67585.

[7] Hugosson J, Carlsson S, Aus G, Bergdahl S, Khatami A, Lodding P, et al. Mortality results from the Göteborg randomised population-based prostate-cancer screening trial. The Lancet Oncology. 2010; 11: 725–732.

[8] Frånlund M, Månsson M, Godtman RA, Aus G, Holmberg E, Kollberg KS, et al. Results from 22 years of Followup in the Göteborg randomized population-based prostate cancer screening trial. The Journal of Urology. 2022; 208: 292–300.

[9] Hugosson J, Roobol MJ, Månsson M, Tammela TLJ, Zappa M, Nelen V, et al. A 16-yr follow-up of the european randomized study of screening for prostate cancer. European Urology. 2019; 76: 43–51.

[10] Martin RM, Donovan JL, Turner EL, Metcalfe C, Young GJ, Walsh EI, et al. Effect of a low-intensity PSA-based screening intervention on prostate cancer mortality: the CAP randomized clinical trial. JAMA. 2018; 319: 883–895.

[11] Pinsky PF, Prorok PC, Yu K, Kramer BS, Black A, Gohagan JK, et al. Extended mortality results for prostate cancer screening in the PLCO trial with median follow-up of 15 years. Cancer. 2017; 123: 592–599.

[12] Andriole GL, Crawford ED, Grubb III RL, Buys SS, Chia D, Church TR, et al. Mortality results from a randomized prostate-cancer screening trial. The New England Journal of Medicine. 2009; 360: 1310–1319.

[13] Obiora D, Orikogbo O, Davies BJ, Jacobs BL. Controversies in prostate cancer screening. To be published in Urologic Oncology. 2024. [Preprint].

[14] van As NJ, Norman AR, Thomas K, Khoo VS, Thompson A, Huddart RA, et al. Predicting the probability of deferred radical treatment for localised prostate cancer managed by active surveillance. European Urology. 2008; 54: 1297–1305.

[15] Jemal A, Culp MB, Ma J, Islami F, Fedewa SA. Prostate cancer incidence 5 years after US preventive services task force recommendations against screening. Journal of the National Cancer Institute. 2021; 113: 64–71.

[16] Carlsson S, Assel M, Sjoberg D, Ulmert D, Hugosson J, Lilja H, et al. Influence of blood prostate specific antigen levels at age 60 on benefits and harms of prostate cancer screening: population based cohort study. The BMJ. 2014; 348: g2296.

[17] Urata S, Kitagawa Y, Matsuyama S, Naito R, Yasuda K, Mizokami A, et al. Optimal screening interval for men with low baseline prostate-specific antigen levels (≤1.0 ng/mL) in a prostate cancer screening program. World Journal of Urology. 2017; 35: 579–586.

[18] Vickers AJ, Ulmert D, Sjoberg DD, Bennette CJ, Björk T, Gerdtsson A, et al. Strategy for detection of prostate cancer based on relation between prostate specific antigen at age 40–55 and long term risk of metastasis: case-control study. The BMJ. 2013; 346: f2023.

[19] Gelfond J, Choate K, Ankerst DP, Hernandez J, Leach RJ, Thompson IM. Intermediate-term risk of prostate cancer is directly related to baseline prostate specific antigen: implications for reducing the burden of prostate specific antigen screening. The Journal of Urology. 2015; 194: 46–51.

[20] Kalish LA, McKinlay JB. Serum prostate-specific antigen levels (PSA) in men without clinical evidence of prostate cancer: age-specific reference ranges for total PSA, free PSA, and percent free PSA. Urology. 1999; 54: 1022–1027.

[21] Xie G, Huang Y, Yan C, PU J, LI G, Ouyang J, et al. Analysis of age-specific prostate specific antigen and related parameters in 22 055 elderly men. Chinese Journal of Urology. 2013; 613–617. (In Chinese)

[22] Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level ≤4.0 ng per milliliter. The New England Journal of Medicine. 2004; 350: 2239–2246.

[23] Cao X, Gao J, Han G, Tang J, Hong B. Relationship between screening by stratifying cases into groups on prostate specific antigen level and the positive rate of transrectal ultrasound guided systematic sextant prostate biopsy. Chinese Journal of Surgery. 2006; 44: 372–375. (In Chinese)

[24] Krilaviciute A, Becker N, Lakes J, Radtke JP, Kuczyk M, Peters I, et al. Digital rectal examination is not a useful screening test for prostate cancer. European Urology Oncology. 2023; 6: 566–573.


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