title: Prostate cancer detection by prostate-specific antigen-based screening in the Japanese Hiroshima area shows early stage, low-grade, and low rate of cancer-specific death compared with clinical detection.
abstract: BACKGROUND
  We investigate the effectiveness of prostate-specific antigen (PSA) screening for prostate cancer. We compare the characteristics of 2 sets of patients: (1) those in whom prostate cancer was detected via PSA screening (the PS group) and (2) those in whom prostate cancer was detected at the outpatient office (the non-PS group).
  
  
  METHODS
  Between 2002 and 2010, prostate cancer was detected in 315 patients by PSA screening. Their age, initial PSA level, pathological findings in biopsy specimens, clinical stage, and prognosis were compared with those of 497 prostate cancer patients diagnosed at the outpatient office of the Department of Urology, Hiroshima University, in the same period.
  
  
  RESULTS
  The rates of patients with initial PSA higher than 50 ng/mL, with a Gleason score of 8 or higher, and with clinical stage D were significantly lower in the PS group than those in the non-PS group. The 5-year overall survival and cancer-specific survival in the PS group was 91.3% and 98.2%, respectively; these results were significantly better than those in the non-PS group (86.4%, p = 0.0178, and 94.9%, p = 0.0112, respectively). A Cox hazard analysis showed that PSA screening was an independent predictive factor for cancer-specific survival.
  
  
  CONCLUSIONS
  Although our study is limited by its retrospective nature and small size, the present data indicate that prostate cancer detected in the PS group showed earlier stage, lower grade, and better prognosis than in the non-PS group.
authors.affiliation: Department of Urology, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;
authors.forename: Jun
authors.initials: J
authors.lastname: Teishima
authors.affiliation: Department of Urology, Hiroshima General Hospital, Hatsukaichi, Japan;
authors.forename: Satoshi
authors.initials: S
authors.lastname: Maruyama
authors.affiliation: Department of Urology, Miyoshi Prefectural Hospital, Miyoshi, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Mochizuki
authors.affiliation: Department of Urology, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Oka
authors.affiliation: Department of Urology, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Ikeda
authors.affiliation: Department of Urology, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;
authors.forename: Keisuke
authors.initials: K
authors.lastname: Goto
authors.affiliation: Department of Urology, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Nagamatsu
authors.affiliation: Department of Urology, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hieda
authors.affiliation: Department of Urology, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;
authors.forename: Koichi
authors.initials: K
authors.lastname: Shoji
authors.affiliation: Department of Urology, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;
authors.forename: Akio
authors.initials: A
authors.lastname: Matsubara