title: A seven-year follow-up of men following a benign prostate biopsy.
abstract: OBJECTIVE
  To determine the incidence and clinical relevance of newly diagnosed cases of prostate cancer in a group of men who had an elevated PSA and benign prostate biopsy 7 years previously.
  
  
  METHODS
  Patients under the age of 80 years with an elevated PSA who had had a benign prostate biopsy in the 12 months between March 1, 1994 and February 28, 1995 were studied. One hundred and sixty four patients with a mean age of 66.8 years (range 47-79 years) were identified. The mean PSA for this group was 10.3ng/ml (range 4.1-81ng/ml). One hundred and fifty nine of the 164 (97%) hospital records were available for review and all but 21 (12.8%) of the General Practitioners were contacted.
  
  
  RESULTS
  Eighteen (11%) of the original 164 patients were subsequently diagnosed with prostate cancer, 2 died from their disease.
  
  
  CONCLUSIONS
  In a population where the follow-up of patients with a benign biopsy was arranged on clinical grounds alone, 11% of the study group were diagnosed with prostate cancer during a seven-year follow-up. Although some of these cancers appear to be slow growing, most of those diagnosed in the initial follow-up period were deemed to be clinically significant and a small proportion progressed rapidly to metastases. All patients who have an elevated PSA, but benign biopsy, should undergo a period of PSA monitoring until it is clear that their PSA is not rising. We propose an initial intensive monitoring period to avoid missing those with clinically aggressive disease.
authors.affiliation: Department of Urology, Royal Berkshire and Battle Hospitals, Oxford Road, Reading RG30 1AG, UK. boddyjane@hotmail.com
authors.forename: Jane L
authors.initials: JL
authors.lastname: Boddy
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Pike
authors.forename: Peter R
authors.initials: PR
authors.lastname: Malone
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D001707:Biopsy, Needle; D015331:Cohort Studies; D005188:False Negative Reactions; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000379:methods; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000601:surgery; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D018570:Risk Assessment; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000379:methods
chemical_list: D017430:Prostate-Specific Antigen