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  • Frånlund, MariaGothenburg University,Göteborgs universitet,University of Gothenburg,Sahlgrenska University Hospital,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology (author)

Prostate cancer risk assessment in men with an initial P.S.A. below 3 ng/mL : results from the Göteborg randomized population-based prostate cancer screening trial

  • Article/chapterEnglish2018

Publisher, publication year, extent ...

  • 2018-09-21
  • Medical Journals Sweden AB,2018

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  • LIBRIS-ID:oai:lup.lub.lu.se:599be6c2-4a8a-4151-9068-6c0bb06cd9b8
  • https://lup.lub.lu.se/record/599be6c2-4a8a-4151-9068-6c0bb06cd9b8URI
  • https://doi.org/10.1080/21681805.2018.1508166DOI
  • https://gup.ub.gu.se/publication/274804URI

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  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

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  • Abstract Objective: To evaluate the long-term outcome of men with an initial prostate-specific antigen (PSA) level below 3 ng/mL and whether the free-to-total (F/T PSA) ratio is a useful prognostic marker in this range. Materials and methods: This study is based on 5,174 men aged 50–66 years, who in 1995–1996 participated in the first round of the Göteborg randomized screening trial (initial T-PSA level <3 ng/mL). These men were subsequently invited biennially for PSA and F/T PSA screening until they reached the upper age limit (on average 69 years). Biopsy was recommended if PSA ≥ 3 ng/mL. Results: After a median follow-up of 18.9 years, 754 men (14.6%) were diagnosed with prostate cancer (PC). The overall cumulative PC incidence was 17.2%. It increased from 7.9% among men with T-PSA of ≤0.99 ng/mL to 26.0% in men with T-PSA levels of 1–1.99 ng/mL and 40.3% in men between 2–2.99 ng/mL (p < 0.001). The initial PSA was also related to the incidence of Gleason ≥7 PC (3.7% vs 9.7% vs 10.9%) and PC death (0.3% vs 1.1% vs 1.5%). Adding F/T PSA did not improve PC prediction in terms of Harrell concordance index (base model 0.76 vs 0.76) nor improvement of the likelihood of the model (p = 0.371). Conclusions: Some men with initial PSA < 3 ng/mL will be diagnosed too late, despite participating in an organized screening program, indicating that prompt diagnosis is justified in these men. PC incidence and risk of PC death was associated with PSA., but F/T PSA had no predictive value.

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  • Godtman, Rebecka Arnsrud,1981Gothenburg University,Göteborgs universitet,University of Gothenburg,Sahlgrenska University Hospital,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology(Swepub:gu)xgodre (author)
  • Carlsson, Sigrid V.Gothenburg University,Göteborgs universitet,University of Gothenburg,Sahlgrenska University Hospital,Memorial Sloan-Kettering Cancer Center,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology(Swepub:gu)xcasig (author)
  • Lilja, HansLund University,Lunds universitet,Klinisk kemi, Malmö,Forskargrupper vid Lunds universitet,Clinical Chemistry, Malmö,Lund University Research Groups,Skåne University Hospital,University of Oxford,Memorial Sloan-Kettering Cancer Center(Swepub:lu)klke-hli (author)
  • Månsson, Marianne,1964Gothenburg University,Göteborgs universitet,University of Gothenburg,Sahlgrenska University Hospital,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology(Swepub:gu)xmanma (author)
  • Stranne, Johan,1970Gothenburg University,Göteborgs universitet,University of Gothenburg,Sahlgrenska University Hospital,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology(Swepub:gu)xstraj (author)
  • Hugosson, Jonas,1955Gothenburg University,Göteborgs universitet,University of Gothenburg,Sahlgrenska University Hospital,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology(Swepub:gu)xhugjo (author)
  • University of GothenburgSahlgrenska University Hospital (creator_code:org_t)

Related titles

  • In:Scandinavian Journal of Urology: Medical Journals Sweden AB52:4, s. 256-2622168-18052168-1813

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