title: Clinical and pathological features of screen vs non-screen-detected prostate cancers: is there a difference?
abstract: 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.
authors.affiliation: Department of Urology, Medical University Innsbruck, Austria. alexandre.pelzer@gmail.com
authors.forename: Alexandre E
authors.initials: AE
authors.lastname: Pelzer
authors.forename: Daniela
authors.initials: D
authors.lastname: Colleselli
authors.forename: Jasmin
authors.initials: J
authors.lastname: Bektic
authors.forename: Georg
authors.initials: G
authors.lastname: Schaefer
authors.forename: Stefano
authors.initials: S
authors.lastname: Ongarello
authors.forename: Christian
authors.initials: C
authors.lastname: Schwentner
authors.forename: Leo
authors.initials: L
authors.lastname: Pallwein
authors.forename: Michael
authors.initials: M
authors.lastname: Mitterberger
authors.forename: Eberhard
authors.initials: E
authors.lastname: Steiner
authors.forename: Georg
authors.initials: G
authors.lastname: Bartsch
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Horninger
mesh_terms: 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
chemical_list: D017430:Prostate-Specific Antigen