UroToday - Prostate-Specific Antigen at or before Age 50 as a Predictor of Advanced Prostate Cancer Diagnosed up to 25 Years Later: A Case-Control Study - Abstract

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Wednesday, 19 March 2008

Based on a large, representative unscreened cohort from MalmAP, Sweden, we

have recently reported that a single prostate-specific antigen (PSA)

measurement at or before age 50 is a strong predictor of prostate cancer

occurring up to 25 years subsequently. We aimed to determine whether this

association holds for advanced cancers, defined as clinical stage T3 or

higher, or skeletal metastasis at the time of the cancer diagnosis.

In 1974-1986 blood samples were obtained from a cohort of 21,277 men aged up

to 50. Through 1999, 498 men were diagnosed with prostate cancer, and of

these 161 had locally advanced or metastatic prostate cancers. Three

controls, matched for age and date of venipuncture, were selected for each

case. Conditional logistic regression was used to test associations between

molecular markers and advanced cancer.

Median time from venipuncture to diagnosis was 17 years. Levels of all PSA

forms and hK2 were associated with case status. Total PSA was a strong and

statistically significant predictor of subsequent advanced cancer (area

under the curve 0.791; p < 0.0001). Two-thirds of the advanced cancer cases

occurred in men with the top 20% of PSA levels (0.9 ng/ml or higher).

A single PSA test taken at or before age 50 is a very strong predictor of

advanced prostate cancer diagnosed up to 25 years later. This suggests the

possibility of using an early PSA test to risk-stratify patients so that men

at highest risk are the focus of the most intensive screening efforts.

Written by

Ulmert D, Cronin AM, Bjork T, O'Brien MF, Scardino PT, Eastham JA, Becker C,

Berglund G, Vickers AJ, Lilja H.

Reference

BMC Med. 2008 Feb 15;6(1):6.

doi:10.1186/1741-7015-6-6

PubMed Abstract

PMID:18279502