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Prostate‐specific antigen patterns in US and European populations: comparison of six diverse cohorts
Author(s) -
Simpkin Andrew J.,
Donovan Jenny L.,
Tilling Kate,
Athene Lane J.,
Martin Richard M.,
Albertsen Peter C.,
BillAxelson Anna,
Ballentine Carter H.,
Bosch J. L. H Ruud,
Ferrucci Luigi,
Hamdy Freddie C.,
Holmberg Lars,
Jeffrey Metter E.,
Neal David E.,
Parker Christopher C.,
Metcalfe Chris
Publication year - 2016
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13422
Subject(s) - prostate cancer , medicine , prostate specific antigen , cohort , confidence interval , cancer , oncology , prostate , cohort study , antigen , demography , gynecology , immunology , sociology
Objective To determine whether there are differences in prostate‐specific antigen ( PSA ) levels at diagnosis or changes in PSA levels between US and European populations of men with and without prostate cancer ( PC a). Subjects and Methods We analysed repeated measures of PSA from six clinically and geographically diverse cohorts of men: two cohorts with PSA ‐detected PC a, two cohorts with clinically detected PC a and two cohorts without PC a. Using multilevel models, average PSA at diagnosis and PSA change over time were compared among study populations. Results The annual percentage PSA change of 4–5% was similar between men without cancer and men with PSA ‐detected cancer. PSA at diagnosis was 1.7 ng/ mL lower in a US cohort of men with PSA ‐detected PC a (95% confidence interval 1.3–2.0 ng/mL), compared with a UK cohort of men with PSA ‐detected PC a, but there was no evidence of a different rate of PSA change between these populations. Conclusion We found that PSA changes over time are similar in UK and US men diagnosed through PSA testing and even in men without PC a. Further development of PSA models to monitor men on active surveillance should be undertaken in order to take advantage of these similarities. We found no evidence that guidelines for using PSA to monitor men cannot be passed between US and European studies.