Clinical and pathological features of screen vs non-screen-detected prostate cancers: is there a difference?
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.


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.


CONCLUSIONS
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.
Pelzer
Alexandre E
AE
Department of Urology, Medical University Innsbruck, Austria. alexandre.pelzer@gmail.com
Colleselli
Daniela
D
Bektic
Jasmin
J
Schaefer
Georg
G
Ongarello
Stefano
S
Schwentner
Christian
C
Pallwein
Leo
L
Mitterberger
Michael
M
Steiner
Eberhard
E
Bartsch
Georg
G
Horninger
Wolfgang
W
D000368:Aged; D001317:Austria; D015331:Cohort Studies; D042241:Early Diagnosis; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D015397:Program Evaluation; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery
D017430:Prostate-Specific Antigen