Detection rates of high-grade prostate cancer during subsequent screening visits. Results of the European Randomized Screening Study for Prostate Cancer.
Screening for prostate cancer using prostate-specific antigen (PSA) tests has led to a stage and grade shift as compared to the pre-PSA era. Effectiveness of screening for prostate cancer should be manifested by a reduction in detection rate of aggressive cancers during subsequent screening. In 6 centers of the European Randomized Screening study for Prostate Cancer, a total of 58,710 men were tested for prostate cancer. Screening centers differed with regard to age-range, screening interval and biopsy indications. During the 2nd visit, the proportion of Gleason score 6 cancers increased from 62.5 to 75%, mainly at the expense of Gleason score 7 cancers. High-grade (Gleason score 8-10) cancer detection rates varied per screening center during the 1st visit from 5.1 to 41.1, and during the 2nd visit from 6.4 to 29.3/10,000 men. The overall detection rate of high-grade cancers showed a reduction during the 2nd visit from 26 to 12/10,000 men, an effect mainly attributable to the screening center with the highest cancer detection rate (i.e. 507/10,000 men). Variations in detection rates among screening centers related among others to biopsy compliance and age range.
van der Kwast
Theodorus H
TH
Department of Pathology and Urology, Erasmus Medical Center, Rotterdam, the Netherlands, and Centro per la Studio e la Prevenzione Oncologica, University of Florence, Italy. tvanderkwast@mtsinai.on.ca
Ciatto
Stefano
S
Martikainen
Paula M
PM
Hoedemaeker
Robert
R
Laurila
Marita
M
Pihl
Carl-Gustaph
CG
Hugosson
Jonas
J
Neetens
Ingrid
I
Nelen
Vera
V
Di Lollo
Simonetta
S
Roobol
Monique J
MJ
Määtänen
Liisa
L
Santonja
Carlos
C
Moss
Sue
S
Schröder
Fritz H
FH
D000367:Age Factors; D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D010349:Patient Compliance; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D015203:Reproducibility of Results
D017430:Prostate-Specific Antigen