Abstract
BackgroundIn daily routine business, various prostate-specific antigen (PSA) retest strategies are being promoted. ObjectiveTo investigate rescreening intervals according to baseline PSA <3 ng/ml stratified by any and aggressive prostate cancer (PCa). Design, setting, and participantsFrom 1998 to 2012, data from 4350 men aged 55–70 yr were analyzed from a population-based prospective screening study (median follow-up: 11.6 yr). Outcome measurements and statistical analysisThe primary end point was detection of aggressive PCa (Gleason score 7–10). Cox regression analysis was used to examine the relationship between covariates. Results and limitationsBaseline PSA of <1.0 ng/ml, 1–1.9 ng/ml, and 2–2.9 ng/ml was present in 2416 men (55.5%: group 1), 1371 men (31.6%: group 2), and 563 men (12.9%: group 3), respectively. Stratified according to these PSA groups, aggressive PCa was detected in 25 patients (1.0%), 80 patients (5.8%), and 34 patients (6.0%), respectively. During 4 yr, these numbers were 0.0%, 0.29%, and 1.8%, whereas during 8 yr, the numbers were 0.2%, 1.4%, and 2.5%, respectively. In multivariable Cox regression analysis, the only independent risk factor for aggressive PCa was baseline PSA (hazard ratio [HR]: 6.06; 95% confidence interval [CI], 3.82–9.61; p<0.0001, group 2 vs group 1; and HR: 7.33; 95% CI, 4.29–12.52; p<0.0001, group 3 vs group 1). ConclusionsBaseline PSA was the only predictor regarding aggressive PCa. According to the low rate of potentially missed PCa in these groups, rescreening intervals can be safely adapted to baseline PSA values corresponding to a “PSA pyramid”: 6–8 yr if baseline PSA is <1.0 ng/ml, 3–4 yr if baseline PSA is 1–1.99 ng/ml, and yearly if baseline PSA is 2–2.99 ng/ml. Patient summaryWe observed men with a prostate-specific antigen (PSA) value ≤3 ng/ml during 12 yr and found that men can be retested according to their initial PSA value (“PSA pyramid”): PSA <1 (base), retest interval every 8 yr; PSA 1–2 (center), retest interval every 4 yr; and PSA 2–3 (top), retest yearly after risk stratification.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.