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Baseline prostate-specific antigen measurements and subsequent prostate cancer risk in the Danish Diet, Cancer and Health cohort

Larsen, Signe Benzon ; Brasso, Klaus ; Iversen, Peter ; Christensen, Jane ; Christiansen, Michael ; Carlsson, Sigrid LU ; Lilja, Hans LU orcid ; Friis, Soren ; Tjonneland, Anne and Dalton, Susanne Oksbjerg (2013) In European Journal of Cancer 49(14). p.3041-3048
Abstract
Aim: Although prostate-specific antigen (PSA) screening reduces mortality from prostate cancer, substantial over-diagnosis and subsequent overtreatment are concerns. Early screening of men for PSA may serve to stratify the male population by risk of future clinical prostate cancer. Methods and material: Case-control study nested within the Danish 'Diet, Cancer and Health' cohort of 27,179 men aged 50-64 at enrolment. PSA measured in serum collected at cohort entry in 1993-1997 was used to evaluate prostate cancer risk diagnosed up to 14 years after. We identified 911 prostate cancer cases in the Danish Cancer Registry through 31st December 2007 1:1 age-matched with cancer-free controls. Aggressive cancer was defined as >= T3 or Gleason... (More)
Aim: Although prostate-specific antigen (PSA) screening reduces mortality from prostate cancer, substantial over-diagnosis and subsequent overtreatment are concerns. Early screening of men for PSA may serve to stratify the male population by risk of future clinical prostate cancer. Methods and material: Case-control study nested within the Danish 'Diet, Cancer and Health' cohort of 27,179 men aged 50-64 at enrolment. PSA measured in serum collected at cohort entry in 1993-1997 was used to evaluate prostate cancer risk diagnosed up to 14 years after. We identified 911 prostate cancer cases in the Danish Cancer Registry through 31st December 2007 1:1 age-matched with cancer-free controls. Aggressive cancer was defined as >= T3 or Gleason score >= 7 or N1 or M1. Statistical analyses were based on conditional logistic regression with age as underlying time axis. Results: Total PSA and free-to-total PSA ratio at baseline were strongly associated with prostate cancer risk up to 14 years later. PSA was grouped in quintiles and free-to-total PSA ratio divided in three risk groups. The incidence rate ratio for prostate cancer was 150 (95% confidence interval, 72-310) among men with a total PSA in the highest quintile (>5.1 ng/ml) compared to the lowest (<0.80 ng/ml). The risk of aggressive cancer was highly elevated in men with a PSA level in the highest quintile. The results indicate that one-time measurement of PSA could be used in an individualised screening strategy, sparing a large proportion of men from further PSA-based screening. (C) 2013 Elsevier Ltd. All rights reserved. (Less)
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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Prostate neoplasm, Prostate-specific antigen, Baseline, Risk factor, Nested case-control study
in
European Journal of Cancer
volume
49
issue
14
pages
3041 - 3048
publisher
Elsevier
external identifiers
  • wos:000323604700011
  • scopus:84883049851
  • pmid:23684783
ISSN
1879-0852
DOI
10.1016/j.ejca.2013.04.015
language
English
LU publication?
yes
id
887365c4-ab79-4d82-bfc2-40d7d7435c99 (old id 4062794)
date added to LUP
2016-04-01 10:43:39
date last changed
2023-12-21 12:05:57
@article{887365c4-ab79-4d82-bfc2-40d7d7435c99,
  abstract     = {{Aim: Although prostate-specific antigen (PSA) screening reduces mortality from prostate cancer, substantial over-diagnosis and subsequent overtreatment are concerns. Early screening of men for PSA may serve to stratify the male population by risk of future clinical prostate cancer. Methods and material: Case-control study nested within the Danish 'Diet, Cancer and Health' cohort of 27,179 men aged 50-64 at enrolment. PSA measured in serum collected at cohort entry in 1993-1997 was used to evaluate prostate cancer risk diagnosed up to 14 years after. We identified 911 prostate cancer cases in the Danish Cancer Registry through 31st December 2007 1:1 age-matched with cancer-free controls. Aggressive cancer was defined as &gt;= T3 or Gleason score &gt;= 7 or N1 or M1. Statistical analyses were based on conditional logistic regression with age as underlying time axis. Results: Total PSA and free-to-total PSA ratio at baseline were strongly associated with prostate cancer risk up to 14 years later. PSA was grouped in quintiles and free-to-total PSA ratio divided in three risk groups. The incidence rate ratio for prostate cancer was 150 (95% confidence interval, 72-310) among men with a total PSA in the highest quintile (&gt;5.1 ng/ml) compared to the lowest (&lt;0.80 ng/ml). The risk of aggressive cancer was highly elevated in men with a PSA level in the highest quintile. The results indicate that one-time measurement of PSA could be used in an individualised screening strategy, sparing a large proportion of men from further PSA-based screening. (C) 2013 Elsevier Ltd. All rights reserved.}},
  author       = {{Larsen, Signe Benzon and Brasso, Klaus and Iversen, Peter and Christensen, Jane and Christiansen, Michael and Carlsson, Sigrid and Lilja, Hans and Friis, Soren and Tjonneland, Anne and Dalton, Susanne Oksbjerg}},
  issn         = {{1879-0852}},
  keywords     = {{Prostate neoplasm; Prostate-specific antigen; Baseline; Risk factor; Nested case-control study}},
  language     = {{eng}},
  number       = {{14}},
  pages        = {{3041--3048}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Cancer}},
  title        = {{Baseline prostate-specific antigen measurements and subsequent prostate cancer risk in the Danish Diet, Cancer and Health cohort}},
  url          = {{http://dx.doi.org/10.1016/j.ejca.2013.04.015}},
  doi          = {{10.1016/j.ejca.2013.04.015}},
  volume       = {{49}},
  year         = {{2013}},
}