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The influence of serial prostate‐specific antigen (PSA) screening on the PSA velocity at diagnosis
Author(s) -
Martin Neil E.,
Chen MingHui,
Catalona William J.,
Loeb Stacy,
Roehl Kimberly A.,
D'Amico Anthony V.
Publication year - 2008
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/cncr.23609
Subject(s) - medicine , prostate cancer , prostatectomy , prostate specific antigen , urology , prostate , logistic regression , prospective cohort study , gynecology , cancer
BACKGROUND. A prostate‐specific antigen (PSA) velocity (PSAV) >2 ng/mL during the year before diagnosis has been associated with an increased risk of prostate cancer‐specific mortality (PCSM) after radical prostatectomy (RP) or radiation therapy. The objective of the current study was to examine whether the proportion of men with a PSAV >2 ng/mL per year has changed significantly during the PSA era. METHODS. The authors evaluated 1095 men from a prospective prostate cancer screening study who underwent RP between 1989 and 2002. For the purposes of this analysis, clinicopathologic features were compared between men who were treated during the following 3 periods: before 1995, from 1995 to 1998, and after 1998. Logistic regression analysis was used to evaluate for an association between the year of diagnosis and the proportion of men with a PSAV >2 ng/mL per year. RESULTS. Two hundred sixty‐two of 1095 men (24%) had a PSAV >2 ng/mL per year. There was a statistically significant reduction in the proportion of men presenting with a PSAV >2 ng/mL per year over the study period. Specifically, 35% of men presented with a PSAV >2 ng/mL per year in the early period compared with only 22% and 12% in the middle and late periods, respectively ( P < .001). Over the studied periods, there also was a significantly greater proportion of men with >2 PSA values obtained before diagnosis ( P < .001). CONCLUSIONS. Men who were screened serially with PSA were less likely to present with a PSAV >2 ng/mL per year. This association lends support to the hypothesis that serial PSA‐based screening may lead to a decrease in PCSM. Cancer 2008. © 2008 American Cancer Society.