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Prediction of Significant Prostate Cancer Diagnosed 20 to 30 Years Later With a Single Measure of Prostate-Specific Antigen at or Before Age 50

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. (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)
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author
organization
publishing date
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
external identifiers
  • wos:000288349300013
  • scopus:79952133146
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
2011-04-04 13:02:36
date last changed
2017-10-01 03:29:35
@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},
  keyword      = {prostate cancer,prostate-specific antigen,human kallikrein 2,risk,factors,case-control study},
  language     = {eng},
  number       = {6},
  pages        = {1210--1219},
  publisher    = {John Wiley & Sons},
  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},
  volume       = {117},
  year         = {2011},
}