title: Prostate-specific antigen patterns in US and European populations: comparison of six diverse cohorts.
abstract: OBJECTIVE
  To determine whether there are differences in prostate-specific antigen (PSA) levels at diagnosis or changes in PSA levels between US and European populations of men with and without prostate cancer (PCa).
  
  
  METHODS
  We analysed repeated measures of PSA from six clinically and geographically diverse cohorts of men: two cohorts with PSA-detected PCa, two cohorts with clinically detected PCa and two cohorts without PCa. Using multilevel models, average PSA at diagnosis and PSA change over time were compared among study populations.
  
  
  RESULTS
  The annual percentage PSA change of 4-5% was similar between men without cancer and men with PSA-detected cancer. PSA at diagnosis was 1.7 ng/mL lower in a US cohort of men with PSA-detected PCa (95% confidence interval 1.3-2.0 ng/mL), compared with a UK cohort of men with PSA-detected PCa, but there was no evidence of a different rate of PSA change between these populations.
  
  
  CONCLUSIONS
  We found that PSA changes over time are similar in UK and US men diagnosed through PSA testing and even in men without PCa. Further development of PSA models to monitor men on active surveillance should be undertaken in order to take advantage of these similarities. We found no evidence that guidelines for using PSA to monitor men cannot be passed between US and European studies.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Simpkin
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Jenny L
authors.initials: JL
authors.lastname: Donovan
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Tilling
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: J
authors.initials: J
authors.lastname: Athene Lane
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.|NIHR Bristol Nutrition Biomedical Research Unit, University of Bristol, Bristol, UK.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Martin
authors.affiliation: Division of Urology, University of Connecticut Health Center, Farmington, CT, USA.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Albertsen
authors.affiliation: Institution of Surgical Sciences, Department of Urology, Uppsala University, Uppsala, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Bill-Axelson
authors.affiliation: Department of Urology, Johns Hopkins School of Medicine, Baltimore, MA, USA.
authors.forename: H
authors.initials: H
authors.lastname: Ballentine Carter
authors.affiliation: Department of Urology, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: J L H Ruud
authors.initials: JL
authors.lastname: Bosch
authors.affiliation: National Institute on Aging, National Institutes of Health, Baltimore, MA, USA.
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.affiliation: Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
authors.forename: Freddie C
authors.initials: FC
authors.lastname: Hamdy
authors.affiliation: Faculty of Life Sciences and Medicine, King's College London, London, UK.|Regional Cancer Centre, Uppsala/Örebro Region, Uppsala, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Holmberg
authors.affiliation: Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: E
authors.initials: E
authors.lastname: Jeffrey Metter
authors.affiliation: Department of Oncology, University of Cambridge, Cambridge, UK.
authors.forename: David E
authors.initials: DE
authors.lastname: Neal
authors.affiliation: Academic Urology Unit, Royal Marsden Hospital, Institute of Cancer Research, London, UK.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Parker
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Metcalfe
mesh_terms: D005060:Europe; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D006113:United Kingdom; D014481:United States; D057832:Watchful Waiting
chemical_list: D017430:Prostate-Specific Antigen
keywords: active surveillance; prostate cancer; prostate specific antigen