Abstract
BackgroundIn May 2012 the US Preventive Task Force issued a ‘D’ recommendation against routine PSA-based early detection of prostate cancer. This recommendation was implemented progressively in our health system. The aim of this study is to define its impact on prostate cancer staging at a tertiary care institution.MethodsA retrospective analysis was performed from 2012 until 2015 at a single center. We analyzed the total number of biopsies performed per year and the positive biopsy rate. For those patients with positive biopsies we recorded diagnostic PSA, clinical stage, ISUP grade group, nodal involvement and metastatic status at diagnosis.ResultsA total of 1686 biopsies were analyzed. The positive biopsy rate increased from 25% in 2012 to 40% in 2015 (p < 0.05). No change in median PSA was noticed (p = 0.627). The biopsies detected higher ISUP grades (p = 0.000). In addition, newly diagnosed prostate cancer presented a higher clinical stage (p = 0.005), higher metastatic rates (p = 0.03) and a tendency to higher lymph node involvement although not statistically significant (p = 0.09).ConclusionAfter the 2012 recommendation, patients presented a higher probability of a prostate cancer diagnosis, with a more adverse ISUP group, clinical stage and metastatic disease.These results should be taken into consideration to implement a risk adapted strategy for prostate cancer screening.
Highlights
In May 2012 the US Preventive Task Force issued a ‘D’ recommendation against routine prostate specific antigen (PSA)-based early detection of prostate cancer
In May 2012 the US Preventive Task Force (USPTF) issued a ‘D’ recommendation for routine PSA-based early detection of prostate cancer, stating that it should not be offered in the general U.S population, regardless of age [13]
Patients were excluded from the analysis if they had been previously diagnosed with prostate cancer or had prostatic intraepithelial neoplasia (PIN) or atypical small acinar proliferation (ASAP) in the absence of any prostatic adenocarcinoma
Summary
In May 2012 the US Preventive Task Force issued a ‘D’ recommendation against routine PSA-based early detection of prostate cancer. This recommendation was implemented progressively in our health system. In May 2012 the US Preventive Task Force (USPTF) issued a ‘D’ recommendation for routine PSA-based early detection of prostate cancer, stating that it should not be offered in the general U.S population, regardless of age [13]. This recommendation was based on the results of two randomized trials willing to prove whether screening. The aim of this study is to analyze the impact of the 2012 recommendation at our institution in terms of prostate cancer diagnosis and clinical staging
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