Prostate specific antigen changes as related to the initial prostate specific antigen: data from the prostate, lung, colorectal and ovarian cancer screening trial

The Journal of Urology
E David CrawfordJohn K Gohagan

Abstract

Annual screening with PSA, although of unproven benefit, is currently used for prostate cancer early detection. A large fraction of screened men have low (less than 2 ng/ml) initial PSA. The yield over time of positive PSA screens (ie more than 4 ng/ml) in these men has not been well characterized in large cohorts in the United States. Men in the screening arm of the PLCO received baseline PSA and annual tests for 5 years. 30,495 of these men had baseline PSA 4 ng/ml or less. We estimated the cumulative probability of converting to PSA greater than 4 at years 1 through 5 as a function of baseline PSA. Among men with baseline PSA less than 1 ng/ml, 1.5% converted by year 5 (95% CI 1.2-1.7). Among men with baseline PSA of 1.0 to 1.99 ng/ml, 1.2% (95% CI 0.9-1.3) and 7.4% (95% CI 6.8-8.1) converted by year 1 and 5, respectively. A total of 33.5% and 79% of men with initial PSA of 2.0 to 2.99 and 3.0 to 4.0, respectively, converted by year 5. Of men with baseline PSA less than 1 ng/ml converting to PSA more than 4 ng/ml, 8% were diagnosed with cancer within 2 years of conversion. About 10% of men with baseline PSA less than 1 ng/ml and negative baseline DRE had a positive DRE within 3 years. For men choosing PSA screening, screenin...Continue Reading

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Citations

Mar 17, 2007·World Journal of Urology·C H BangmaF H Schröder
Aug 31, 2007·Journal of the National Cancer Institute·E David Crawford
May 19, 2009·Asian Journal of Andrology·Maria Chiara SighinolfiGiampaolo Bianchi
Apr 11, 2007·BJU International·Anita V MitraUNKNOWN IMPACT Steering Committee and Collaborators
May 5, 2004·The Urologic Clinics of North America·Shandra S Wilson, E David Crawford
Nov 13, 2007·European Urology·Fritz H SchröderMonique J Roobol
Jan 24, 2008·Nature Clinical Practice. Urology·Hong Gee Sim, Christopher Cheng
Jun 30, 2011·BJU International·E David CrawfordAlexa Hughes
Dec 25, 2016·The Journal of Urology·Alan W Partin

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