Cancer Detection and Cancer Characteristics in the European Randomized Study of Screening for Prostate Cancer (ERSPC) – Section Rotterdam

Postma, Renske; Schröder, Fritz H.; Leenders, Geert J.L.H. van; Hoedemaeker, Robert F.; Vis, André N.; Roobol, Monique J.; Kwast, Theodorus H. van der

doi:10.1016/j.eururo.2007.01.030

Cited by 103 publications

(67 citation statements)

References 27 publications

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“…While the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial and European Randomized Study of Screening for Prostate Cancer (ERSPC) trials address directly whether prostate cancer screening can reduce deaths, recent studies have raised questions whether screening programs can impact cancer death rates [2,3]. Lung cancer screening by spiral CT scans of the chest does increase *Address correspondence to this author at the Department of Urology, Room S287, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305-5118, USA; Tel: 650-725-5546; Fax: 650-723-4200; E-mail: jdbrooks@stanford.edu Supported by the National Institutes of Health grant CA111782 and a Stanford University Bio-X Interdisciplinary Initiatives Award detection of low volume, stage 1 cancers and the number of surgeries performed [4].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Tumor Volume on Outcomes after Radical Prostatectomy: Implications for Prostate Cancer Screening

Brooks¹,

Tibshirani²,

Ferrari³

et al. 2008

TOPCANJ

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Abstract:Purpose: For screening to make an impact on prostate cancer mortality, detection of potentially lethal cancers at an early stage when they are low volume should result in improved recurrence and death rates after treatment. Patients and Methods:The effect of tumor volume on prostate cancer recurrence and death was evaluated in 764 men who underwent radical prostatectomy between 1984 and 2004, with particular attention focused on patients with moderate and high risk features. Results: Tumor volume was a powerful predictor of recurrence in men after radical prostatectomy with moderate and high risk features, even after accounting for the effects of percentage Gleason pattern 4/5 cancer, extracapsular extension, seminal vesicle invasion, lymph node metastasis, pre-operative PSA, and surgical margin involvement. In a subset of 159 patients for whom pre-operative PSA velocity was available, tumor volume predicted recurrence in those in the highest risk category (PSAV > 2 ng/ml/yr). Tumor volume, along with percent grade 4/5 and positive surgical margins, was significantly associated with prostate cancer specific death. Conclusions:The association of volume with outcome after radical prostatectomy, particularly in high risk patients, suggests that screening has made a positive impact on prostate cancer mortality. Future screening efforts should be directed at finding cancers with moderate and high risk features at low volume.

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Section: Introductionmentioning

confidence: 99%

The Impact of Tumor Volume on Outcomes after Radical Prostatectomy: Implications for Prostate Cancer Screening

Brooks¹,

Tibshirani²,

Ferrari³

et al. 2008

TOPCANJ

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“…The PLCO outcomes indicated a larger positive predictive value for the first PSA screening, 28 and the ERSPC trial also found that cancers detected with the initial screening were more likely to be advanced stage. 30 This may explain the larger number of individuals diagnosed with prostate cancer with a first screen in the younger age groups.…”

Section: Discussionmentioning

confidence: 99%

Historical Prostate Cancer Screening and Treatment Outcomes from a Single Institution

Cross

Ritter

Reding

2012

Clinical Medicine & Research

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Objective: To quantify outcomes of individuals diagnosed and treated for prostate cancer in a single institution. Design: Retrospective electronic chart abstraction.Setting: Marshfield Clinic, the largest private multispecialty group practice in Wisconsin, and one of the largest in the United States, provides health care services annually to approximately 385,000 unique patients through 1.8 million annual patient encounters.Participants: Individuals within the Marshfield Clinic cancer registry who had been diagnosed with prostate cancer between 1960 and 2009. Methods:Electronic chart abstraction from the cancer registry and the electronic medical record was conducted (N=6,181). Data abstracted included age at diagnosis; stage and grade of tumor; prostate specific antigen (PSA) values before, at, and after diagnosis; initial cancer treatment; follow-up time; subsequent cancer treatments; evidence of metastasis; age of death; and cause of death, if known. Results:The average age of prostate cancer diagnosis has decreased from 70-71 years in the 1960's and 1970's to an average age at diagnosis of 67 years in the 2000's (P<0.001). This decrease in age occurred within the decades of implementation of PSA screening. Approximately 74% of men diagnosed with prostate cancer within the PSA screening era had at least one PSA test, and the presence of a PSA test did not appear to change treatment outcome. Age, grade, and stage were the biggest predictors of prostate cancer outcome. There was no difference in event-free survival between current treatment types (radical prostatectomy, brachytherapy, photon treatment, or intensity-modulated radiation therapy) (2003 or later) when stratified by age (greater than 85%, 5-year event-free survival P=0.85); however, more events occurred with older external beam radiation treatment regimens (1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)) (70% to 75%, 5-year event-free survival P=0.001).Conclusion: Individuals diagnosed and treated for prostate cancer within the Marshfield Clinic comprehensive care setting follow national trends with a decreased age of diagnosis since the advent of PSA screening. Outcomes for individuals treated within the Clinic system are also comparable to national trends.

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“…23 Based on prostatectomy findings, Epstein et al proposed even smaller volume, 0.2 ml as indication of clinically insignificant or minimal cancer, because some prostate cancers with the volume of 0.2-0.5 ml were not organ-confined. 24 Postma et al 25 compared PSA progression after radical prostatectomy to PSA doubling time of watchful waiting policy among patients with focal cancer. The PSA doubling time is used as a variable to observe prostate cancer.…”

Section: Discussionmentioning

confidence: 99%

Biological aggressiveness of prostate cancer in the Finnish screening trial

Laurila

Tammela

Auvinen

et al. 2008

Intl Journal of Cancer

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Prostate cancer aggressiveness was evaluated based on pathologic characterization of cases detected in the Finnish prostate cancer screening trial. The trial population consists of 80,458 men aged 55-67 years. A total of 32,000 men were randomized to the screening arm. The remaining 48,000 men formed the control arm. The interval cases and cancers among nonparticipants and in the control arm were identified from the Finnish Cancer Registry. Random samples were selected from screen-detected cases (126 of 543 in the first and 133 of 508 in the second round) and control arm cancers (133 out of 863), in addition to all 92 interval cancers and 106 cases among nonparticipants. All the biopsies were regraded according to the Gleason system. The expression of the proliferation antigen Ki-67 was determined in 479 cases (72%). More than half of the tumors diagnosed in the first round of screening were high-grade cancers (Gleason 7 or higher). In the second round, the proportion of low-grade cancers increased from 47% to 70%. Cancers in the screening arm were more commonly focal and fewer bilateral cancers were detected. The cancers among nonparticipants were the most aggressive group. The aggressiveness of the interval cancers was between the cancers detected in the first and the second round. Our results indicate that prostate cancers detected through screening are less biologically aggressive. This was most notable after the first screening round. Nonparticipants had more aggressive cancers. ' 2008 Wiley-Liss, Inc.Key words: prostate neoplasms; prostate cancer; screening; prostatespecific antigen; proliferation antigen Prostate cancer is the most commonly diagnosed noncutaneous cancer in men in the Western world and is the second most frequent cause of cancer-related deaths in men.1 More than 95% of malignant prostate neoplasms are adenocarcinomas, and in general, the term prostate cancer is used to designate primary adenocarcinoma. However, prostate cancer comprises a wide spectrum of biological and clinical behavior, ranging from a minute latent tumor to a highly aggressive, life-threatening disease.2 Today, majority of prostate cancers are detected based on serum prostatespecific antigen (PSA). The ultimate goal of prostate cancer screening is to reduce the disease-specific mortality. However, because the biological behavior and the natural course of prostate cancer and its relation to PSA is not known, controlled randomized screening studies are needed to evaluate the effects of early detection and treatment of cancer in mortality and in quality of life.3 The European Randomized Study of Screening for Prostate Cancer (ERSPC) is a multicenter, randomized trial, which started in 1994. 4 Within the ERSPC, approximately 193,000 men from 8 European countries have been randomized, of whom approximately 40% are from Finland with a sample size of approximately 80,000 men. ) is a protein that recognizes nuclear antigens in the cell cycle from the late G1 phase, in S and G2 phases to M phase but not in noncycling cells in G...

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Cancer Detection and Cancer Characteristics in the European Randomized Study of Screening for Prostate Cancer (ERSPC) – Section Rotterdam

Cited by 103 publications

References 27 publications

The Impact of Tumor Volume on Outcomes after Radical Prostatectomy: Implications for Prostate Cancer Screening

The Impact of Tumor Volume on Outcomes after Radical Prostatectomy: Implications for Prostate Cancer Screening

Historical Prostate Cancer Screening and Treatment Outcomes from a Single Institution

Biological aggressiveness of prostate cancer in the Finnish screening trial

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