NDLI: Identification of Clinically Significant Prostate Cancer by Prostate-Specific Antigen Screening

Content Provider	JAMA Network
Author	Smith, Ryan P. Malkowicz, S. Bruce Whittington, Richard VanArsdalen, Keith Tochner, Zelig Wein, Alan J.
Copyright Year	2004
Abstract	Background: The importance of screening for early-stage prostate cancer has been debated in the literature. However, there are well-established prognostic factors ( Gleason score [ GS], pretreatment prostate-specific antigen [ PSA], and percent positive biopsy findings [%+ Bx]) that predict biologically aggressive disease. These factors, together with a patient's age and general state of health, will permit physicians to project the effect of a prostate tumor over the patient's expected lifetime. This study was performed to determine the proportion of clinically significant prostate cancers diagnosed in a screened population. Methods: From 1991 through 2002, 977 patients with nonpalpable ( T1c) prostate cancer were seen for evaluation and comprise the study group. Patients were classified according to pretreatment PSA level, GS, %+ Bx, and age. Results: Based on tumor characteristics alone, 130 patients were noted to be at high risk ( GS = 8-10 or PSA level >20 ng/m: L; or GS = 7 or PSA level >10-≤20 ng/m: L and >50%+ Bx), with a historical 4-year PSA control of 10% to 30% after definitive therapy. An additional 45 patients were at intermediate risk ( GS = 7, PSA level >10-≤20 ng/m: L, and 34%-50%+ Bx), with a historical 4-year PSA control of 50% to 60% after definitive therapy. Additional patients were identified who had a cumulative anticipated prostate cancer mortality greater than 30% to 50% based on age and GS ( GS = 7, age ≤70 years [n = 89]; GS = 6, age ≤65 years [n = 337]). The total at risk for clinically significant tumors was 601 (61.5%) of 977 patients. Conclusions: A significant proportion of patients with nonpalpable disease diagnosed as having prostate cancer by PSA screening have clinically significant cancers. This supports the continued use of PSA screening.
Ending Page	1230
Starting Page	1227
Page Count	4
File Format	PDF HTM / HTML
ISSN	00039926
DOI	10.1001/archinte.164.11.1227
Issue Number	11
Journal	Archives of Internal Medicine
Volume Number	164
Language	English
Publisher	American Medical Association
Publisher Date	2004-06-14
Access Restriction	Open
Subject Keyword	neoplasms prostate cancer prostate-specific antigen screening prostate-specific antigen cancer screening biopsy gleason grading system for prostatic cancer
Content Type	Text
Resource Type	Article
Subject	Internal Medicine

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
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9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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