You have accessJournal of UrologyProstate Cancer: Detection and Screening III1 Apr 20101984 PROSTATE CANCER RISK IN THE PSA RANGE 1-4NG/ML IN THE PROSPECTIVE SCREENING STUDY Maciej Kwiatkowski, Daniel Seiler, Martin Baumgartner, Stephan Bauer, George Koritsiadis, Andreas Huber, Michael Kurrer, Kurt Lehmann, and Franz Recker Maciej KwiatkowskiMaciej Kwiatkowski Aarau, Switzerland More articles by this author , Daniel SeilerDaniel Seiler Aarau, Switzerland More articles by this author , Martin BaumgartnerMartin Baumgartner Aarau, Switzerland More articles by this author , Stephan BauerStephan Bauer Aarau, Switzerland More articles by this author , George KoritsiadisGeorge Koritsiadis Aarau, Switzerland More articles by this author , Andreas HuberAndreas Huber Aarau, Switzerland More articles by this author , Michael KurrerMichael Kurrer Aarau, Switzerland More articles by this author , Kurt LehmannKurt Lehmann Baden, Switzerland More articles by this author , and Franz ReckerFranz Recker Aarau, Switzerland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1995AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of this study was to investigate the cumulative risk of having prostate cancer (PCa) in low PSA range 1-4 ng/ml in the screened population. In addition the utility of free-to-total PSA ratio (F/T Ratio) was investigated in that setting. The data were gathered prospectively within an ongoing PCa screening trial setting. METHODS 4923 men, participants of the swiss site (Aarau) of the ERSPC screening study, underwent total and free PSA test in the first screening round between 1998 and 2003. 1935 (39.3%) had PSA between 1 and 2.99ng/ml and 238 (4.8%) between 3 and 3.99ng/ml. Free PSA was measured in 1900 and 236 respectively. The TRUS guided prostate biopsy was offered for all men with PSA above 3.0 ng/ml and, as a side study protocol (implemented in the 1st screening round only) all men in the PSA range 1-3 ng/ml were offered a biopsy when F/T Ratio was below 20%. PCa incidence data were available until September 2008. The cumulative incidence rates (CIR) of PCa were calculated. RESULTS Out of 1900 men in the 1-3ng/ml PSA range 430 (22.6%) had F/T Ratio below and 1470 (77.5%) above 20%. 84.4% (363/430) agreed to undergo prostate biopsy resulting in 46 PCa cases (12.7% detection rate). During further follow-up the CIR increased up to 22.8% for this group (98/430) whereas for the F/T Ratio above 20% the CIR of 10% (147/1470) was observed. Interval cancers outside the screening study protocol constituted 12.2% (12/430) and 13.6% (20/147) of all PCa detected in respective groups. Out of 236 men in the 3-4ng/ml PSA range 111 (47%) had F/T Ratio below and 125 (53%) above 20%. 89.8% (212/236) agreed for prostate biopsy. The PCa detection rate was 24.3% (25/103) below and 15.6% (17/109) above F/T Ratio 20% cutoff respectively. With further follow-up the CIR increased up to 36% (40/111) for F/T Ratio below, and up to 30.4% (38/125) for F/T Ratio above 20% cutoff. Interval cancers constituted 12.5% (5/40) and 23.7% (9/38) of all PCa detected in respective groups. CONCLUSIONS This study shows that there is a substantial risk of having biopsy detectable PCa in low PSA ranges and that total PSA and F/T Ratio can to some extent predict PCa risk. In the range 3-4ng/ml the PCa risk in the 1st screening round was 1.6 stronger associated with F/T Ratio below vs. above 20% cutoff but this ratio decreased to 1.2 during 10 years follow-up. In the range 1-3ng/ml the cumulative risk ratio was even higher (2.3) but as we biopsied only men with F/T Ratio below 20%, we are thus unable to predict how many of these cancers would have emerged during the follow-up. A comparative study with similar but unbiopsied population is needed to investigate this question. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e770-e771 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maciej Kwiatkowski Aarau, Switzerland More articles by this author Daniel Seiler Aarau, Switzerland More articles by this author Martin Baumgartner Aarau, Switzerland More articles by this author Stephan Bauer Aarau, Switzerland More articles by this author George Koritsiadis Aarau, Switzerland More articles by this author Andreas Huber Aarau, Switzerland More articles by this author Michael Kurrer Aarau, Switzerland More articles by this author Kurt Lehmann Baden, Switzerland More articles by this author Franz Recker Aarau, Switzerland More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...