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Clinical and pathological features of screen vs non‐screen‐detected prostate cancers: is there a difference?
Author(s) -
Pelzer Alexandre E.,
Colleselli Daniela,
Bektic Jasmin,
Schaefer Georg,
Ongarello Stefano,
Schwentner Christian,
Pallwein Leo,
Mitterberger Michael,
Steiner Eberhard,
Bartsch Georg,
Horninger Wolfgang
Publication year - 2008
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/j.1464-410x.2008.07566.x
Subject(s) - medicine , pathological , prostate cancer , prostate , prostatectomy , surgical margin , prostate specific antigen , stage (stratigraphy) , urology , significant difference , cancer , oncology , gynecology , paleontology , biology
OBJECTIVE To evaluate the clinical and pathological characteristics of screen vs non‐screen‐detected prostate cancers, to determine if there is a difference in the same prostate‐specific antigen (PSA) range. PATIENTS AND METHODS In all, 997 patients who had had a radical prostatectomy were evaluated; 806 were Tyrolean screening volunteers, and 191 were from outside Tyrol, representing the ‘referred prostate cancer’ group. PSA level, age, prostate volume and pathological characteristics were assessed, as was the amount of over‐ and under‐diagnosis. RESULTS There were no statistically significant differences in patient age or PSA levels in the two groups. Even in the same PSA range there were statistically significantly more extraprostatic cancers in the referral group, at 31.7% and 17.4%, respectively. In the referred and screening groups there was over‐diagnosis in 7.9% and 16.8%, and under‐diagnosis in 40.8% and 27.8%, respectively. CONCLUSION This study suggests that screening volunteers have a statistically significantly higher rate of organ‐confined prostate cancers, and a statistically significantly lower rate of extracapsular extension and positive surgical margins than their counterparts in the referral group even in the same PSA range. As the pathological stage and surgical margin status are significant predictors of recurrence, these findings support the concept of PSA screening.