title: Clinical outcomes of prostate cancer patients in Yokosuka City, Japan: A comparative study between cases detected by prostate-specific antigen-based screening in Yokosuka and those detected by other means.
abstract: OBJECTIVE
  To investigate whether prostate-specific antigen-based screening reduced the prostate cancer mortality rate in Yokosuka, Japan.
  
  
  METHODS
  We carried out a cohort study, in which we compared clinical outcomes between patients detected by prostate-specific antigen-based screening (S group n = 524) versus those detected by other means (NS group n = 1044). Clinical and pathological factors were evaluated using Cox regression analyses and the Kaplan-Meier method.
  
  
  RESULTS
  A total of 1.5% (8/524) of patients in the S group and 6.7% (70/1044) of those in the NS group died from prostate cancer during follow up. A total of 8.0% (42/524) of patients in the S group and 11.4% (119/1044) in the NS group died from other causes. The 10-year cancer specific survival rates of the S and NS groups were 97% and 86%, respectively (P < 0.001). The median age was significantly lower in the S group than the NS group: 71 and 73 years, respectively (P < 0.001). The rate of Gleason score 8-10 was significantly lower in the S group than the NS group: 9.7% and 16.7%, respectively (P < 0.001). The rate of patients with metastasis or prostate-specific antigen 100 ng/mL or more was significantly lower in the S group than the NS group: 7.8% and 23.0%, respectively (P < 0.001). On multivariate analysis, Gleason score 8-10 compared with Gleason score 6 was independently associated with cancer-specific survival (hazard ratio 4.808, 95% confidence interval 1.044-22.14, P = 0.044).
  
  
  CONCLUSIONS
  Prostate-specific antigen-based population screening in Yokosuka City might help to reduce the prostate cancer mortality rate.
authors.affiliation: Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Sakai
authors.affiliation: Department of Biostatistics and Epidemiology, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Taguri
authors.affiliation: Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan.
authors.forename: Sumio
authors.initials: S
authors.lastname: Noguchi
authors.affiliation: Department of Urology, Kinugasa Hospital, Yokosuka, Kanagawa, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ikeda
authors.affiliation: Department of Urology, Yokosuka City Uwamachi Hospital, Yokosuka, Kanagawa, Japan.
authors.forename: Hideshige
authors.initials: H
authors.lastname: Koh
authors.affiliation: Department of Urology, Satomi Jin-Hinyokika, Yokosuka, Kanagawa, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Satomi
authors.affiliation: Department of Urology, Furuhata Hinyokika Clinic, Yokosuka, Kanagawa, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Furuhata
mesh_terms: D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D055088:Early Detection of Cancer / Q000379:methods*; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D016016:Proportional Hazards Models; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology; D015996:Survival Rate
chemical_list: D017430:Prostate-Specific Antigen
keywords: clinical outcomes; mortality; prostate cancer; prostate-specific antigen; screening