Prostate-specific antigen at or before age 50 as a predictor of advanced prostate cancer diagnosed up to 25 years later: A case-control study

<p>Abstract</p> <p>Background</p> <p>Based on a large, representative unscreened cohort from Malmö, Sweden, we have recently reported that a single prostate-specific antigen (PSA) measurement at or before age 50 is a strong predictor of prostate cancer occurring up to 2...

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Main Authors: Berglund Göran, Vickers Andrew J, Becker Charlotte, Eastham James A, Scardino Peter T, O'Brien Matthew F, Björk Thomas, Cronin Angel M, Ulmert David, Lilja Hans
Format: Article
Language:English
Published: BMC 2008-02-01
Series:BMC Medicine
Online Access:http://www.biomedcentral.com/1741-7015/6/6
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author Berglund Göran
Vickers Andrew J
Becker Charlotte
Eastham James A
Scardino Peter T
O'Brien Matthew F
Björk Thomas
Cronin Angel M
Ulmert David
Lilja Hans
author_facet Berglund Göran
Vickers Andrew J
Becker Charlotte
Eastham James A
Scardino Peter T
O'Brien Matthew F
Björk Thomas
Cronin Angel M
Ulmert David
Lilja Hans
author_sort Berglund Göran
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Based on a large, representative unscreened cohort from Malmö, Sweden, we have recently reported that a single prostate-specific antigen (PSA) measurement at or before age 50 is a strong predictor of prostate cancer occurring up to 25 years subsequently. We aimed to determine whether this association holds for advanced cancers, defined as clinical stage T3 or higher, or skeletal metastasis at the time of the cancer diagnosis.</p> <p>Methods</p> <p>In 1974–1986 blood samples were obtained from a cohort of 21,277 men aged up to 50. Through 1999, 498 men were diagnosed with prostate cancer, and of these 161 had locally advanced or metastatic prostate cancers. Three controls, matched for age and date of venipuncture, were selected for each case. Conditional logistic regression was used to test associations between molecular markers and advanced cancer.</p> <p>Results</p> <p>Median time from venipuncture to diagnosis was 17 years. Levels of all PSA forms and hK2 were associated with case status. Total PSA was a strong and statistically significant predictor of subsequent advanced cancer (area under the curve 0.791; <it>p </it>< 0.0005). Two-thirds of the advanced cancer cases occurred in men with the top 20% of PSA levels (0.9 ng/ml or higher).</p> <p>Conclusion</p> <p>A single PSA test taken at or before age 50 is a very strong predictor of advanced prostate cancer diagnosed up to 25 years later. This suggests the possibility of using an early PSA test to risk-stratify patients so that men at highest risk are the focus of the most intensive screening efforts.</p>
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spelling doaj.art-72ffacd0108b46019c38c8c5639d32ba2022-12-21T19:43:23ZengBMCBMC Medicine1741-70152008-02-0161610.1186/1741-7015-6-6Prostate-specific antigen at or before age 50 as a predictor of advanced prostate cancer diagnosed up to 25 years later: A case-control studyBerglund GöranVickers Andrew JBecker CharlotteEastham James AScardino Peter TO'Brien Matthew FBjörk ThomasCronin Angel MUlmert DavidLilja Hans<p>Abstract</p> <p>Background</p> <p>Based on a large, representative unscreened cohort from Malmö, Sweden, we have recently reported that a single prostate-specific antigen (PSA) measurement at or before age 50 is a strong predictor of prostate cancer occurring up to 25 years subsequently. We aimed to determine whether this association holds for advanced cancers, defined as clinical stage T3 or higher, or skeletal metastasis at the time of the cancer diagnosis.</p> <p>Methods</p> <p>In 1974–1986 blood samples were obtained from a cohort of 21,277 men aged up to 50. Through 1999, 498 men were diagnosed with prostate cancer, and of these 161 had locally advanced or metastatic prostate cancers. Three controls, matched for age and date of venipuncture, were selected for each case. Conditional logistic regression was used to test associations between molecular markers and advanced cancer.</p> <p>Results</p> <p>Median time from venipuncture to diagnosis was 17 years. Levels of all PSA forms and hK2 were associated with case status. Total PSA was a strong and statistically significant predictor of subsequent advanced cancer (area under the curve 0.791; <it>p </it>< 0.0005). Two-thirds of the advanced cancer cases occurred in men with the top 20% of PSA levels (0.9 ng/ml or higher).</p> <p>Conclusion</p> <p>A single PSA test taken at or before age 50 is a very strong predictor of advanced prostate cancer diagnosed up to 25 years later. This suggests the possibility of using an early PSA test to risk-stratify patients so that men at highest risk are the focus of the most intensive screening efforts.</p>http://www.biomedcentral.com/1741-7015/6/6
spellingShingle Berglund Göran
Vickers Andrew J
Becker Charlotte
Eastham James A
Scardino Peter T
O'Brien Matthew F
Björk Thomas
Cronin Angel M
Ulmert David
Lilja Hans
Prostate-specific antigen at or before age 50 as a predictor of advanced prostate cancer diagnosed up to 25 years later: A case-control study
BMC Medicine
title Prostate-specific antigen at or before age 50 as a predictor of advanced prostate cancer diagnosed up to 25 years later: A case-control study
title_full Prostate-specific antigen at or before age 50 as a predictor of advanced prostate cancer diagnosed up to 25 years later: A case-control study
title_fullStr Prostate-specific antigen at or before age 50 as a predictor of advanced prostate cancer diagnosed up to 25 years later: A case-control study
title_full_unstemmed Prostate-specific antigen at or before age 50 as a predictor of advanced prostate cancer diagnosed up to 25 years later: A case-control study
title_short Prostate-specific antigen at or before age 50 as a predictor of advanced prostate cancer diagnosed up to 25 years later: A case-control study
title_sort prostate specific antigen at or before age 50 as a predictor of advanced prostate cancer diagnosed up to 25 years later a case control study
url http://www.biomedcentral.com/1741-7015/6/6
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