title: Differences among men on active surveillance for very low-risk prostate cancer detected through population-based versus opportunistic prostate-specific antigen-screening.
abstract: BACKGROUND
  Very low-risk prostate cancer (PCa) is being increasingly managed by active surveillance (AS). Our aim was to assess the influence of the origin of diagnosis on PCa characteristics and treatment rates among men with very low-risk PCa in our prospective AS cohort.
  
  
  METHODS
  Overall, 191 men with very low-risk PCa fulfilling Epstein-criteria underwent protocol-based AS. These men originated either from the prospective population-based screening program (P-AS) or were diagnosed by opportunistic screening (O-AS).
  
  
  RESULTS
  Overall, n = 86 (45.0%) originated from the P-AS group, whereas n = 105 (55.0%) from the O-AS group. On univariate Cox regression analysis, age (HR 0.96, 95% CI 0.92-1.00; p = 0.05), origin of diagnosis (HR 0.72, 95% CI 0.41-1.28; p = 0.001), number of positive cores (HR 2.15, 95% CI 1.18-3.90; p = 0.01) and maximum core involvement (HR 1.03, 95% CI 0.99-1.05; p = 0.05) were predictors for treatment necessity. On multivariate analysis, age (HR 0.95, 95% CI 0.89-0.99; p = 0.05), number of positive cores (HR 2.07, 95% CI 1.10-3.88; p = 0.02), maximum core involvement (HR 1.03, 95% CI 1.00-1.06; p = 0.04) but not origin of diagnosis were independent predictors for treatment necessity. Four men developed biochemical recurrence (all from O-AS group [p = 0.05]).
  
  
  CONCLUSIONS
  The origin of PCa diagnosis in men undergoing AS had no influence on disease progression and treatment necessity.
authors: Department of Urology, Cantonal Hospital Aarau, Switzerland.
authors: Marco
authors: M
authors: Randazzo
authors: Josef
authors: J
authors: Beatrice
authors: Andreas
authors: A
authors: Huber
authors: Rainer
authors: R
authors: Grobholz
authors: Lukas
authors: L
authors: Manka
authors: Franz
authors: F
authors: Recker
authors: Maciej
authors: M
authors: Kwiatkowski
mesh_terms: D000368:Aged; D001706:Biopsy; D018450:Disease Progression; D055088:Early Detection of Cancer; D005060:Europe; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D057832:Watchful Waiting
chemical_list: D017430:Prostate-Specific Antigen