Prediction of Significant Prostate Cancer Diagnosed 20 to 30 Years Later With a Single Measure of Prostate-Specific Antigen at or Before Age 50
(2011) In Cancer 117(6). p.1210-1219- 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... (More)
- 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% Cl, 0.70-0.74; for advanced cancer, 0.75; 95% Cl, 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% Cl, 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. Cancer 2011;117:1210-9. (C) 2010 American Cancer Society (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1868570
- author
- Lilja, Hans LU ; Cronin, Angel M. ; Dahlin, Anders LU ; Manjer, Jonas LU ; Nilsson, Peter LU ; Eastham, James A. ; Bjartell, Anders LU ; Scardino, Peter T. ; Ulmert, David LU and Vickers, Andrew J.
- organization
- publishing date
- 2011
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- prostate cancer, prostate-specific antigen, human kallikrein 2, risk, factors, case-control study
- in
- Cancer
- volume
- 117
- issue
- 6
- pages
- 1210 - 1219
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- wos:000288349300013
- scopus:79952133146
- pmid:20960520
- ISSN
- 1097-0142
- DOI
- 10.1002/cncr.25568
- language
- English
- LU publication?
- yes
- id
- 8f62fc02-b76c-4a53-aefc-9b06b17c00e1 (old id 1868570)
- date added to LUP
- 2016-04-01 11:04:26
- date last changed
- 2022-05-18 08:11:08
@article{8f62fc02-b76c-4a53-aefc-9b06b17c00e1, 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% Cl, 0.70-0.74; for advanced cancer, 0.75; 95% Cl, 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% Cl, 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. Cancer 2011;117:1210-9. (C) 2010 American Cancer Society}}, author = {{Lilja, Hans and Cronin, Angel M. and Dahlin, Anders and Manjer, Jonas and Nilsson, Peter and Eastham, James A. and Bjartell, Anders and Scardino, Peter T. and Ulmert, David and Vickers, Andrew J.}}, issn = {{1097-0142}}, keywords = {{prostate cancer; prostate-specific antigen; human kallikrein 2; risk; factors; case-control study}}, language = {{eng}}, number = {{6}}, pages = {{1210--1219}}, publisher = {{John Wiley & Sons Inc.}}, series = {{Cancer}}, 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}}, url = {{http://dx.doi.org/10.1002/cncr.25568}}, doi = {{10.1002/cncr.25568}}, volume = {{117}}, year = {{2011}}, }