Is further screening of men with baseline PSA < 1 ng ml−1 worthwhile? The discussion continues—Results of the Swiss ERSPC (Aarau). Issue 3 (23rd January 2015)

• Record Type: Journal Article
• Authors: Randazzo, Marco; Beatrice, Josef; Huber, Andreas; Grobholz, Rainer; Manka, Lukas; Chun, Felix K.; Kluth, Luis A.; Wyler, Stephen F.; Recker, Franz; Kwiatkowski, Maciej
• Is Part Of: International journal of cancer. Volume 137:Issue 3(2015:Aug. 01)
• Page Start: 553
• Page End: 559
• Publication Date: 2015-01-23
• Subjects: Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.29420
• Languages: English
• ISSNs: 0020-7136

Abstract

&lt;abstract abstract-type=&quot;main&quot;&gt; &lt;title&gt; &lt;x xml:space=&quot;preserve&quot;&gt;Abstract&lt;/x&gt; &lt;/title&gt; &lt;p&gt;Recent studies indicate frequent early PSA retesting unrelated of men&#39;s baseline PSA, which increases the harms of early detection especially among men with low PSA. The current study investigates the PCa incidence among men with baseline PSA &amp;lt;1.0 ng ml&lt;sup&gt;−1&lt;/sup&gt; in order to adjust retest intervals for more targeted early detection. Between 1998 and 2012, 2, 416 men with baseline PSA &amp;lt;1.0 ng ml&lt;sup&gt;−1&lt;/sup&gt; were prospectively observed. Primary endpoint was PCa diagnosis. Negative predictive value (NPV) and number needed to screen (NNS) to detect one PCa were calculated. During a median follow‐up time of 12.1 years, 54 (2.2%) PCa were diagnosed with &lt;italic&gt;n&lt;/italic&gt; = 26 (48.1%) among men with baseline PSA of 0.75 ≤ 1.0 ng ml&lt;sup&gt;−1&lt;/sup&gt; (upper baseline PSA quartile). The 10‐year probability of being diagnosed with PCa increased significantly from 0.19% (baseline PSA &amp;lt; 0.40 ng ml&lt;sup&gt;−1&lt;/sup&gt;) to 2.0% (baseline PSA 0.40 ≤ 0.56 ng ml&lt;sup&gt;−1&lt;/sup&gt;), 2.5% (baseline PSA 0.56 ≤ 0.75 ng ml&lt;sup&gt;−1&lt;/sup&gt;) over 4.4% (baseline PSA 0.75 ≤ 1.0 ng ml&lt;sup&gt;−1&lt;/sup&gt;) (all &lt;italic&gt;p&lt;/italic&gt; values &amp;lt;0.0001), respectively. The frequency of Gleason ≥7 PCa increased from 1 (0.17%) to 8 (1.4%), 5 (0.8) over 11 (1.8%) in these groups. The 8‐year NPV for Gleason ≥ 7 PCa were 99.8 (baseline PSA &amp;lt; 0.40 ng ml&lt;sup&gt;−1&lt;/sup&gt;), 99.8 (baseline PSA 0.40 ≤ 0.56 ng ml&lt;sup&gt;−1&lt;/sup&gt;), 100 (baseline PSA 0.56 ≤ 0.75 ng ml&lt;sup&gt;−1&lt;/sup&gt;) and 99.5 (baseline PSA 0.75 ≤ 1.0 ng ml&lt;sup&gt;−1&lt;/sup&gt;), respectively. During 12 years, the numbers were 99.8, 98.6, 99.2, and 98.2, respectively. Therefore, due to the very low rate of Gleason ≥ 7 PCa, further screening might be omitted in men with baseline PSA &amp;lt; 0.4 ng ml&lt;sup&gt;−1&lt;/sup&gt;. Between 0.4 and 1.0 ng ml&lt;sup&gt;−1&lt;/sup&gt;, an 8‐year interval can be discussed.&lt;/p&gt; &lt;/abstract&gt;