Long-term Outcomes for Men in a Prostate Screening Trial with an Initial Benign Prostate Biopsy: A Population-based Cohort

• Background: The optimal follow-up regimen for men after a benign prostate biopsy remains unknown. Objective: To investigate long-term outcomes for men after an initial benign prostate biopsy. Design, setting, and participants: All men with a benign biopsy in the first screening round of the Goteborg prostate cancer (PC) screening trial were included. The follow-up period was January 1, 1995-May 15, 2017. Intervention: Prostate-specific antigen (PSA) tests were performed every second year (upper median age limit 69 yr). Men with PSA >= 3 ng/ml underwent prostate biopsy (sextant biopsy up to 2009). Outcome measurement and statistical analysis: The 20-yr cumulative PC incidence and PC mortality were calculated using the 1 minus Kaplan-Meier method. Results and limitations: Of 452 men with a benign biopsy and followed for a median of 21.1 yr, 169 were diagnosed with PC and five died from PC. The 20-yr cumulative PC incidence and PC mortality were 40.0% and 1.4%, respectively. The corresponding figures were 38.8% and 0.6% for men with initial PSA <= 10 ng/ml, and 64.4% and 21.4% for PSA >10 ng/ml. The proportion of men untreated at final follow-up was similar in the two PSA groups (22% vs 23%). The use of sextant biopsy for many years of the trial is a limitation. Conclusions: Men with an initial benign prostate biopsy run a very low risk of dying from PC when participating in a screening program. However, if followed for a long period, many men will be diagnosed and treated for PC. Low-intensity follow-up, as in the Goteborg trial, appears sufficient for men with PSA <= 10 ng/ml after a benign biopsy. Patient summary: This study shows that men who participate in a prostate cancer screening trial have a low risk of dying from prostate cancer if the first biopsy does not show cancer. (C) 2019 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Urology and Nephrology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

Benign biopsy

Mortality

Prostate-specific antigen

Prostate cancer

cancer

accuracy

Oncology

Urology & Nephrology

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