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Prostate Specific Antigen and Prostate Cancer in Chinese Men Undergoing Initial Prostate Biopsies Compared with Western Cohorts

Chen, Rui ; Sjoberg, Daniel D. ; Huang, Yiran ; Xie, Liping ; Zhou, Liqun ; He, Dalin ; Vickers, Andrew J. and Sun, Yinghao (2017) In Journal of Urology 197(1). p.90-96
Abstract

Purpose We determined the characteristics of Chinese men undergoing initial prostate biopsy and evaluated the relationship between prostate specific antigen levels and prostate cancer/high grade prostate cancer detection in a large Chinese multicenter cohort. Materials and Methods This retrospective study included 13,904 urology outpatients who had undergone biopsy for the indications of prostate specific antigen greater than 4.0 ng/ml or prostate specific antigen less than 4.0 ng/ml but with abnormal digital rectal examination results. The prostate specific antigen measurements were performed in accordance with the standard procedures at the respective institutions. The type of assay used was documented and recalibrated to the WHO... (More)

Purpose We determined the characteristics of Chinese men undergoing initial prostate biopsy and evaluated the relationship between prostate specific antigen levels and prostate cancer/high grade prostate cancer detection in a large Chinese multicenter cohort. Materials and Methods This retrospective study included 13,904 urology outpatients who had undergone biopsy for the indications of prostate specific antigen greater than 4.0 ng/ml or prostate specific antigen less than 4.0 ng/ml but with abnormal digital rectal examination results. The prostate specific antigen measurements were performed in accordance with the standard procedures at the respective institutions. The type of assay used was documented and recalibrated to the WHO standard. Results The incidence of prostate cancer and high grade prostate cancer was lower in the Chinese cohort than the Western cohorts at any given prostate specific antigen level. Around 25% of patients with a prostate specific antigen of 4.0 to 10.0 ng/ml were found to have prostate cancer compared to approximately 40% in U.S. clinical practice. Moreover, the risk curves were generally flatter than those of the Western cohorts, that is risk did not increase as rapidly with higher prostate specific antigen. Conclusions The relationship between prostate specific antigen and prostate cancer risk differs importantly between Chinese and Western populations, with an overall lower risk in the Chinese cohort. Further research should explore whether environmental or genetic differences explain these findings or whether they result from unmeasured differences in screening or benign prostate disease. Caution is required for the implementation of prostate cancer clinical decision rules or prediction models for men in China or other Asian countries with similar genetic and environmental backgrounds.

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author
; ; ; ; ; ; and
contributor
Sun, Yinghao and LU orcid
author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
biopsy, China, early detection of cancer, prostate-specific antigen, prostatic neoplasms
in
Journal of Urology
volume
197
issue
1
pages
7 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:27593477
  • scopus:85003434274
ISSN
0022-5347
DOI
10.1016/j.juro.2016.08.103
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2017 American Urological Association Education and Research, Inc.
id
63149040-75fc-492d-a26d-6d60b0b7799d
date added to LUP
2023-02-10 11:02:49
date last changed
2024-04-17 23:47:56
@article{63149040-75fc-492d-a26d-6d60b0b7799d,
  abstract     = {{<p>Purpose We determined the characteristics of Chinese men undergoing initial prostate biopsy and evaluated the relationship between prostate specific antigen levels and prostate cancer/high grade prostate cancer detection in a large Chinese multicenter cohort. Materials and Methods This retrospective study included 13,904 urology outpatients who had undergone biopsy for the indications of prostate specific antigen greater than 4.0 ng/ml or prostate specific antigen less than 4.0 ng/ml but with abnormal digital rectal examination results. The prostate specific antigen measurements were performed in accordance with the standard procedures at the respective institutions. The type of assay used was documented and recalibrated to the WHO standard. Results The incidence of prostate cancer and high grade prostate cancer was lower in the Chinese cohort than the Western cohorts at any given prostate specific antigen level. Around 25% of patients with a prostate specific antigen of 4.0 to 10.0 ng/ml were found to have prostate cancer compared to approximately 40% in U.S. clinical practice. Moreover, the risk curves were generally flatter than those of the Western cohorts, that is risk did not increase as rapidly with higher prostate specific antigen. Conclusions The relationship between prostate specific antigen and prostate cancer risk differs importantly between Chinese and Western populations, with an overall lower risk in the Chinese cohort. Further research should explore whether environmental or genetic differences explain these findings or whether they result from unmeasured differences in screening or benign prostate disease. Caution is required for the implementation of prostate cancer clinical decision rules or prediction models for men in China or other Asian countries with similar genetic and environmental backgrounds.</p>}},
  author       = {{Chen, Rui and Sjoberg, Daniel D. and Huang, Yiran and Xie, Liping and Zhou, Liqun and He, Dalin and Vickers, Andrew J. and Sun, Yinghao}},
  issn         = {{0022-5347}},
  keywords     = {{biopsy; China; early detection of cancer; prostate-specific antigen; prostatic neoplasms}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{1}},
  pages        = {{90--96}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Urology}},
  title        = {{Prostate Specific Antigen and Prostate Cancer in Chinese Men Undergoing Initial Prostate Biopsies Compared with Western Cohorts}},
  url          = {{http://dx.doi.org/10.1016/j.juro.2016.08.103}},
  doi          = {{10.1016/j.juro.2016.08.103}},
  volume       = {{197}},
  year         = {{2017}},
}