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Opportunistic prost...
Opportunistic prostate-specific antigen testing in Norwegian men: a public health challenge
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Albertsen, P. C. (author)
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Bjerner, L. J. (author)
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Pasovic, L. (author)
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Müller, S. (author)
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Fosså, S. (author)
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- Carlsson, Sigrid V (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology
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Oldenburg, J. (author)
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(creator_code:org_t)
- 2024
- 2024
- English.
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In: Bju International. - 1464-4096. ; 133:1, s. 104-111
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
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- Objective To describe age-specific prostate-specific antigen (PSA) distributions and resulting prostate cancer diagnoses that arise from population-wide opportunistic PSA testing.Patients and Methods Over 8 million PSA tests were performed on >1.4 million Norwegian men from 2000 to 2020. During this period 43 486 men were diagnosed with localised prostate cancer. Most of the PSA testing reflected opportunistic testing. Age-specific PSA value distributions were constructed for men aged 45-75 years with and without prostate cancer.Results The distributions of PSA values in men with and without prostate cancer widened with age and overlapped extensively from 3 to 7 ng/mL. Localised prostate cancer diagnoses increased 10-fold from the age of 45 to 75 years. PSA testing identified intermediate- or high-grade cancers in 21% (95% confidence interval [CI] 19-23%) of men aged 50-54 years and 42% (95% CI 41-43%) of men aged 70-74 years. Grade group (GG)1, GG2, GG3 and >= GG4 constituted 49%, 31%, 10% and 10% of cancers identified at age 50-54 years and 26%, 26%, 18%, and 30% of cancers identified at age 70-74 years.Conclusion Opportunistic PSA testing increases with ageing and often generates values that cannot discriminate benign prostate enlargement from prostate cancer. A clinical cascade using additional imaging or serum tests is necessary to avoid negative biopsies and the overdiagnosis of indolent disease. The declining specificity of PSA testing with ageing poses a significant public health challenge especially among older men aged >= 70 years.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Keyword
- cancer screening
- prostate cancer
- prostate cancer mortality
- PSA
- public health
- cancer mortality
- serum
- psa
- population
- Urology & Nephrology
Publication and Content Type
- ref (subject category)
- art (subject category)
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