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Prostate cancer awareness week. Education, service, and research in a community setting
Author(s) -
Deantoni Edward P.,
Crawford E. David
Publication year - 1995
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19950401)75:7+<1874::aid-cncr2820751618>3.0.co;2-i
Subject(s) - medicine , cancer , service (business) , prostate cancer , family medicine , gerontology , medical education , oncology , gynecology , economy , economics
Prostate cancer awareness week began in 1989 to recruit asymptomatic men to have prostate screening examinations using digital rectal examination and prostate‐specific antigen (PSA) testing. In 6 years 2,000,000 men have participated. A measure of cancer screening and early detection efficacy is the distribution by stage of diagnosed cancers. Less than a decade ago, 10% of clinically diagnosed prostate cancers were Stage A (T 0 ,.T 1 ,), 15‐20% were Stage B (T 2 ), 40% were Stage C (T 3 ), and the rest were Stage D (T 4 ). In 1993, localized disease (T 0 ‐T 2 ) represented 58% of all newly diagnosed cases, representing a substantial increase in the detection of localized disease. Most prostate cancer cases occur in men older than 65 years, but the distribution by stage shows that local disease occurs with proportional frequency among these men. Researchers have noted a relationship of age to PSA. Analysis of 1992 and 1993 cohorts (≅50,000 men) was conducted, and comparable rates of increase by age are noted. Age‐specific PSA reference ranges are outlined by 10‐year age groups. In a cohort of more than 19,000 men tested in both 1992 and 1993, the annual PSA change was 30% among men younger than 70 years, and the change was more than 35% in men 70 years and older. The absolute change in nanograms per milliliter ranged from 0.27 ng/ml in the youngest age group to 0.73 ng/ml among the oldest men. Continued elevations or substantial interval increases in PSA with time may be more important than absolute PSA values. Prostate‐specific antigen velocity permits continued investigation of interval screening of asymptomatic men. When used in conjunction with digital rectal examination, PSA as a screening test for prostate cancer should be considered an appropriate community‐based health care practice. Cancer 1995;75:1874–9.