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  • Preston, Mark A.Brigham and Women's Hospital / Harvard Medical School (author)

Baseline Prostate-specific Antigen Level in Midlife and Aggressive Prostate Cancer in Black Men

  • Article/chapterEnglish2019

Publisher, publication year, extent ...

  • Elsevier BV,2019

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:56025de3-4213-472a-b911-a637a71a1e06
  • https://lup.lub.lu.se/record/56025de3-4213-472a-b911-a637a71a1e06URI
  • https://doi.org/10.1016/j.eururo.2018.08.032DOI

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  • Language:English
  • Summary in:English

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

Notes

  • Background: Prostate-specific antigen (PSA) measurement in midlife predicts long-term prostate cancer (PCa) mortality among white men. Objective: To determine whether baseline PSA level during midlife predicts risk of aggressive PCa in black men. Design, setting, and participants: Nested case-control study among black men in the Southern Community Cohort Study recruited between 2002 and 2009. A prospective cohort in the southeastern USA with recruitment from community health centers. A total of 197 incident PCa patients aged 40–64 yr at study entry and 569 controls matched on age, date of blood draw, and site of enrollment. Total PSA was measured in blood collected and stored at enrollment. Outcome measurements and statistical analysis: Total and aggressive PCa (91 aggressive: Gleason ≥7, American Joint Committee on Cancer stage III/IV, or PCa-specific death). Exact conditional logistic regression estimated odds ratios (ORs) with 95% confidence intervals (CIs) for PCa by category of baseline PSA. Results and limitations: Median PSA among controls was 0.72, 0.80, 0.94, and 1.03 ng/ml for age groups 40–49, 50–54, 55–59, and 60–64 yr, respectively; 90th percentile levels were 1.68, 1.85, 2.73, and 3.33 ng/ml. Furthermore, 95% of total and 97% of aggressive cases had baseline PSA above the age-specific median. Median follow-up was 9 yr. The OR for total PCa comparing PSA >90th percentile versus ≤median was 83.6 (95% CI, 21.2–539) for 40–54 yr and 71.7 (95% CI, 23.3–288) for 55–64 yr. For aggressive cancer, ORs were 174 (95% CI, 32.3–infinity) for 40–54 yr and 51.8 (95% CI, 11.0–519) for 55–64 yr. A composite endpoint of aggressive PCa based on stage, grade, and mortality was used and is a limitation. Conclusions: PSA levels in midlife strongly predicted total and aggressive PCa among black men. PSA levels among controls were similar to those among white controls in prior studies. Patient summary: Prostate-specific antigen (PSA) level during midlife strongly predicted future development of aggressive prostate cancer among black men. Targeted screening based on a midlife PSA might identify men at high risk while minimizing screening in those men at low risk. Prostate-specific antigen (PSA) level during midlife strongly predicted total and aggressive prostate cancer among black men. Risk-stratified screening based on midlife PSA might retain the benefits of screening while reducing harms.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Gerke, TravisHarvard University,H. Lee Moffitt Cancer Center & Research Institute (author)
  • Carlsson, Sigrid V.Memorial Sloan-Kettering Cancer Center,Sahlgrenska Academy(Swepub:lu)si5270ca (author)
  • Signorello, LisaNational Cancer Institute, USA,Harvard University (author)
  • Sjoberg, Daniel D.Memorial Sloan-Kettering Cancer Center (author)
  • Markt, Sarah C.Harvard University (author)
  • Kibel, Adam S.Brigham and Women's Hospital / Harvard Medical School (author)
  • Trinh, Quoc DienBrigham and Women's Hospital / Harvard Medical School (author)
  • Steinwandel, MarkVanderbilt University (author)
  • Blot, WilliamVanderbilt University (author)
  • Vickers, Andrew J.Memorial Sloan-Kettering Cancer Center (author)
  • Lilja, HansLund University,Lunds universitet,Institutionen för translationell medicin,Medicinska fakulteten,Klinisk kemi, Malmö,Forskargrupper vid Lunds universitet,Department of Translational Medicine,Faculty of Medicine,Clinical Chemistry, Malmö,Lund University Research Groups(Swepub:lu)klke-hli (author)
  • Mucci, Lorelei A.Harvard University (author)
  • Wilson, Kathryn M.Harvard University,Brigham and Women's Hospital / Harvard Medical School (author)
  • Brigham and Women's Hospital / Harvard Medical SchoolHarvard University (creator_code:org_t)

Related titles

  • In:European Urology: Elsevier BV75:3, s. 399-4070302-2838

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