title: Results of compliance with prostate cancer screening guidelines.
abstract: OBJECTIVE
  Current guidelines of the American Cancer Society and the National Comprehensive Cancer Network recommend offering annual prostate cancer screening with prostate specific antigen (PSA) and digital rectal examination (DRE) beginning at age 50 (age 45 in high risk men). There are limited data concerning outcomes if all men followed screening guidelines. We report early outcome data on men who entered a prostate cancer screening study, complied with the screening guidelines and were subsequently diagnosed with prostate cancer.
  
  
  METHODS
  We reviewed records of men 45 to 59 years old at study entry with a PSA less than 2.6 ng/ml and benign DRE who underwent annual DRE and PSA testing in a screening study between 1991 and 2001. Of 10,174 men with these characteristics, 232 (2.3%) were subsequently diagnosed with prostate cancer. We evaluated PSA, Gleason score, clinical and pathological tumor stage, and treatment outcomes in these men.
  
  
  RESULTS
  Median PSA at diagnosis was 3.1 ng/ml (range 0.4 to 9.6). Gleason scores ranged from 4 to 9. All patients had clinically localized disease. Management included predominantly radical prostatectomy (87%) and radiation therapy (10%). Of cancers in which tumor volume was assessed 13% were considered possibly harmless tumors by previously published criteria and 2% were considered possibly rapidly progressive tumors by criteria we set in this study.
  
  
  CONCLUSIONS
  Prostate cancer screening using some current guidelines results in the detection of cancers that are organ confined in 79% of patients, possibly harmless in less than 15% and possibly rapidly progressive in 2%.
authors: Division of Urology, Washington University School of Medicine, St. Louis, Missouri, USA.
authors: Robert L
authors: RL
authors: Grubb
authors: Kimberly A
authors: KA
authors: Roehl
authors: Jo Ann V
authors: JA
authors: Antenor
authors: William J
authors: WJ
authors: Catalona
mesh_terms: D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D010808:Physical Examination; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000517:prevention & control* / Q000601:surgery
chemical_list: D017430:Prostate-Specific Antigen