PSA-based screening for prostate cancer in asymptomatic younger males: pilot study in blood donors.
BACKGROUND
The efficacy and success of a screening program for prostate cancer in young and healthy asymptomatic volunteers are described.


METHODS
In the present study, prostate specific antigen (PSA) samples obtained from 2,272 males (aged 40-65 years) who donated blood at the local Red Cross Blood Bank were evaluated. Two groups of donors were distinguished, which were investigated in different ways. Group 1 comprised individuals aged 40-49 years (n = 568), while group 2 consisted of males aged 50-65 years (n = 1,704). Volunteers in group 2 who had PSA levels greater than 4 ng/ml (n = 302) were referred for ultrasound guided biopsy irrespective of findings on digital rectal examination (DRE). In group 2, individuals with PSA levels exceeding 4 ng/ml and positive DRE findings biopsy specimen was ordered (n = 2). In patients with unremarkable findings on DRE, serum PSA was determined 1 year later and in case of more than 20% increase in the PSA level biopsy was obtained under ultrasound guidance.


RESULTS
The biopsy specimen yielded prostatic carcinoma in 58 patients in group 1. As a screening test, serum PSA determination was superior to digital rectal examination. On digital palpation only 2 presented with abnormal prostates. These 58 patients underwent radical prostatectomy and histological examination revealed organ-confined disease in all but 8. In group 2, in 4 of 12 males the biopsy specimen yielded prostatic carcinoma.


CONCLUSIONS
This study shows that PSA measurement in blood donors is a useful method for recruiting screening volunteers, and therefore represents an additional possibility for early detection of prostate cancer in asymptomatic younger males. Furthermore, it represents an effective tool for following relatively young patients known to have a significant risk of prostate cancer.
Reissigl
A
A
Department of Urology, University of Innsbruck, Austria.
Pointner
J
J
Horninger
W
W
Strasser
H
H
Mayersbach
P
P
Klocker
H
H
Schönitzer
D
D
Bartsch
G
G
D000328:Adult; D000368:Aged; D000375:Aging / Q000378:metabolism*; D000951:Antigens, Neoplasm / Q000097:blood* / Q000378:metabolism; D000954:Antigens, Surface / Q000097:blood* / Q000378:metabolism; D001782:Blood Donors; D002277:Carcinoma / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D043425:Glutamate Carboxypeptidase II; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D010865:Pilot Projects; D017430:Prostate-Specific Antigen / Q000097:blood* / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology
D000951:Antigens, Neoplasm; D000954:Antigens, Surface; C473848:FOLH1 protein, human; D043425:Glutamate Carboxypeptidase II; D017430:Prostate-Specific Antigen