Prostate specific antigen concentration at age 60 and death or metastasis from prostate cancer : Case-control study

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Prostate specific antigen concentration at age 60 and death or metastasis from prostate cancer : Case-control study

Vickers, Andrew J. (author): Memorial Sloan-Kettering Cancer Center

Cronin, Angel M. (author): Memorial Sloan-Kettering Cancer Center

Björk, Thomas (author): Lund University,Lunds universitet,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,Urological cancer, Malmö,Lund University Research Groups,Skåne University Hospital

Manjer, Jonas (author): Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups,Skåne University Hospital

Nilsson, Peter M. (author): Lund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups,Skåne University Hospital

Dahlin, Anders (author): Lund University,Lunds universitet

Bjartell, Anders (author): Lund University,Lunds universitet,Avdelningen för translationell cancerforskning,Institutionen för laboratoriemedicin,Medicinska fakulteten,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,Division of Translational Cancer Research,Department of Laboratory Medicine,Faculty of Medicine,Urological cancer, Malmö,Lund University Research Groups,Skåne University Hospital

Scardino, Peter T. (author): Memorial Sloan-Kettering Cancer Center

Ulmert, David (author): Lund University,Lunds universitet,Tumörmikromiljö,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Strålterapi,Institutionen för kliniska vetenskaper, Lund,Tumor microenvironment,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Radiation therapy,Department of Clinical Sciences, Lund,Memorial Sloan-Kettering Cancer Center,Skåne University Hospital

Lilja, Hans (author): Lund University,Lunds universitet,Klinisk kemi, Malmö,Forskargrupper vid Lunds universitet,Clinical Chemistry, Malmö,Lund University Research Groups,Skåne University Hospital,Memorial Sloan-Kettering Cancer Center

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2010-09-14
2010
English.
In: BMJ (Online). - : BMJ. - 1756-1833 .- 0959-8138 .- 1468-5833. ; 341:7773

Related links:: http://dx.doi.org/10... (free); show more...; https://www.bmj.com/...; https://lup.lub.lu.s...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Objective: To determine the relation between concentrations of prostate specific antigen at age 60 and subsequent diagnosis of clinically relevant prostate cancer in an unscreened population to evaluate whether screening for prostate cancer and chemoprevention could be stratified by risk. Design: Case-control study with 1:3 matching nested within a highly representative population based cohort study. Setting: General population of Sweden taking part in the Malmo Preventive Project. Cancer registry at the National Board of Health and Welfare. Participants: 1167 men aged 60 who provided blood samples in 1981 and were followed up to age 85. Main outcome measures: Metastasis or death from prostate cancer. Results: The rate of screening during the course of the study was low. There were 43 cases of metastasis and 35 deaths from prostate cancer. Concentration of prostate specific antigen at age 60 was associated with prostate cancer metastasis (area under the curve 0.86, 95% confidence interval 0.79 to 0.92; P<0.001) and death from prostate cancer (0.90, 0.84 to 0.96; P<0.001). The greater the number for the area under the curve (values from 0 to 1) the better the test. Although only a minority of the men with concentrations in the top quarter (>2 ng/ml) develop fatal prostate cancer, 90% (78% to 100%) of deaths from prostate cancer occurred in these men. Conversely, men aged 60 with concentrations at the median or lower (≤1 ng/ml) were unlikely to have clinically relevant prostate cancer (0.5% risk of metastasis by age 85 and 0.2% risk of death from prostate cancer). Conclusions: The concentration of prostate specific antigen at age 60 predicts lifetime risk of metastasis and death from prostate cancer. Though men aged 60 with concentrations below the median (≤1 ng/ml) might harbour prostate cancer, it is unlikely to become life threatening. Such men could be exempted from further screening, which should instead focus on men with higher concentrations.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

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By the author/editor: Vickers, Andrew ...; Cronin, Angel M.; Björk, Thomas; Manjer, Jonas; Nilsson, Peter M ...; Dahlin, Anders; show more...; Bjartell, Anders; Scardino, Peter ...; Ulmert, David; Lilja, Hans; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

Articles in the publication: BMJ (Online)

By the university: Lund University

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