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Clinical outcomes of prostate cancer patients in Yokosuka City, Japan: A comparative study between cases detected by prostate‐specific antigen‐based screening in Yokosuka and those detected by other means
Author(s) -
Sakai Naoki,
Taguri Masataka,
Kobayashi Kazuki,
Noguchi Sumio,
Ikeda Shigeru,
Koh Hideshige,
Satomi Yoshiaki,
Furuhata Akihiko
Publication year - 2015
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12806
Subject(s) - medicine , prostate cancer , hazard ratio , prostate specific antigen , proportional hazards model , prostate , confidence interval , pathological , cancer , urology , oncology , cohort , survival rate , antigen , metastasis , immunology
Objectives To investigate whether prostate‐specific antigen‐based screening reduced the prostate cancer mortality rate in Yokosuka, Japan. Methods We carried out a cohort study, in which we compared clinical outcomes between patients detected by prostate‐specific antigen‐based screening (S group n = 524) versus those detected by other means (NS group n = 1044). Clinical and pathological factors were evaluated using Cox regression analyses and the Kaplan–Meier method. Results A total of 1.5% (8/524) of patients in the S group and 6.7% (70/1044) of those in the NS group died from prostate cancer during follow up. A total of 8.0% (42/524) of patients in the S group and 11.4% (119/1044) in the NS group died from other causes. The 10‐year cancer specific survival rates of the S and NS groups were 97% and 86%, respectively ( P < 0.001). The median age was significantly lower in the S group than the NS group: 71 and 73 years, respectively ( P < 0.001). The rate of Gleason score 8–10 was significantly lower in the S group than the NS group: 9.7% and 16.7%, respectively ( P < 0.001). The rate of patients with metastasis or prostate‐specific antigen 100 ng/mL or more was significantly lower in the S group than the NS group: 7.8% and 23.0%, respectively ( P < 0.001). On multivariate analysis, Gleason score 8–10 compared with Gleason score 6 was independently associated with cancer‐specific survival (hazard ratio 4.808, 95% confidence interval 1.044–22.14, P = 0.044). Conclusions Prostate‐specific antigen‐based population screening in Yokosuka City might help to reduce the prostate cancer mortality rate.