MP40-04 THE IMPACT OF FALSE NEGATIVE PROSTATE SPECIFIC ANTIGEN- AND BIOPSY RESULTS IN PROSTATE CANCER SCREENING

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening III1 Apr 2018MP40-04 THE IMPACT OF FALSE NEGATIVE PROSTATE SPECIFIC ANTIGEN- AND BIOPSY RESULTS IN PROSTATE CANCER SCREENING Jan Verbeek and Monique Roobol Jan VerbeekJan Verbeek More articles by this author and Monique RoobolMonique Roobol More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1271AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In prostate cancer (PCa) screening men and their physicians aim to rule out the presence of potentially life threatening PCa. To date, prostate specific antigen (PSA) testing and systematic prostate biopsy (Bx) - in case of an elevated PSA - are still the main modes of PCa detection. Often uncertainty remains when a PSA-test is <3.0 ng/ml or a Bx shows a benign result, leading to the continuous repeating of procedures. Here we assess the potential consequences of false negatives (FN) by studying follow-up data of a purely PSA-based approach applying sextant Bx, an approach considered high risk of missing PCa diagnosis. METHODS Our study population consists of 19970 men from ERSPC section Rotterdam, initially screened in 1993-1999. We assessed the Gleason ≥3+4 PCa (csPCa) diagnosis within the 4-year screening interval and subsequent screening round (4 yr. after initial screening) of men having a PSA <3.0 ng/ml at initial screening (no Bx) and of those men having had a Bx (PSA ≥3.0 ng/ml), with no PCa detected at that time. In addition, we address the PCa mortality and PCa diagnosis for men with a negative PSA test and negative Bx, whom were retested every 4 years, with a 15-year follow-up. RESULTS A total of 15837 men had a PSA <3.0 ng/ml during the initial screening round, of whom 94 (0.6%) were diagnosed with csPCa in a subsequent round and 6 (<0.1%) in the 4 year interval between screening rounds. For 3056 men with a previous negative Bx at 1st screening, the figures were 20 (0.7%) and 2 (<0.1%) respectively. Indolent PCa (Gleason ≤3+3) was diagnosed in 380 (2%) men with an initial PSA <3.0 ng/ml and 125 (4%) men with initial negative Bx. After a 15-year follow-up, 62 (0.4%) PCa deaths occurred in men with initial low PSA and 57 men (0.4%) had metastasis. For men with negative Bx, 14 (0.5%) PCa deaths occurred and 10 (0.3%) experienced metastasis. Fig. 1 illustrates the competing risk of death and PCa diagnosis according to age. CONCLUSIONS The FN rates for PSA <3.0 ng/ml and men with negative sextant Bx are extremely low but not negligible and warrant proper risk stratification before deciding if and when to retest. This is especially relevant with the increase use of the relatively expensive mpMRI guided targeted Bx procedures. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e520-e521 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jan Verbeek More articles by this author Monique Roobol More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...