Early Detection of Prostate Cancer in Germany: A Study Using Digital Rectal Examination and 4.0 ng&amp;sol;ml Prostate&amp;ndash;Specific Antigen as Cutoff

Luboldt, Hans-Joachim; Bex, Axel; Swoboda, A.; Hüsing, Johannes; Rübben, H.

doi:10.1159/000052427

Cited by 32 publications

(30 citation statements)

References 17 publications

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“…12 The lower age limit is less well defined, but is usually 45 to 50 y. 3,11,12 Men with a family history of prostate cancer have a higher risk of prostate cancer, and this is reflected in the high percentage of GPs in our study who PSA test men who have a relative with prostate cancer. 13 The frequency with which screening is performed was not formally assessed in our study.…”

Section: Discussionmentioning

confidence: 93%

“…This is analogous to a previous study analysing PSA testing in general practice, which found that the frequency of PSA testing does not change significantly between age groups between 60 and 80 y old. 10 Although several screening studies regard age 75 as their upper age limit 3,11 , most suggest an upper age limit of 70 y. 12 The lower age limit is less well defined, but is usually 45 to 50 y.…”

Section: Discussionmentioning

confidence: 99%

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PSA testing in general practice

Little

Gormley

et al. 2003

Prostate Cancer Prostatic Dis

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A questionnaire was sent to 400 general practitioners (GPs), concerning prostatespecific antigen (PSA) screening. Regarding the indications for PSA testing, 80% of GPs test men with urinary tract symptoms, 65% test men with a positive family history, 62% test on patient request, and 21% test men with unrelated symptoms. When PSA is measured, 91% of GPs inform their patient, and 71% discuss the significance of an abnormal result. The mean age range for PSA testing was from 50 years, without an upper age limit. The mode PSA threshold for referral was 6.6 ng/ml. De facto PSA screening appears to be widely practised.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

PSA testing in general practice

Little

Gormley

et al. 2003

Prostate Cancer Prostatic Dis

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“…During the past decade the increasing application of PSA test had resulted in a significant increase of annual detection rate of prostate cancer in Taiwan [8]. As in western countries, a PSA level exceeding 4.0 ng/ml was judged as abnormal and prostatic biopsy was recommended [1][2][3]. This widely accepted practice guideline was derived mainly from studies based on U.S. whites, it might not be suitable to be generalized to different races or geographic areas since the inter-racial and geographic difference in prostate cancer incidence is a well-recognized issue [6].…”

Section: Discussionmentioning

confidence: 99%

“…Prostate-specific antigen (PSA) has been widely used for the early detection and screening of prostatic cancers [1][2][3]. Because of the impact of age on the PSA level, Oesterling et al [4] had proposed the 'age-specific PSA reference ranges' to increase the detection of early but clinically important cancers in young men and decrease the number of biopsies in older men.…”

Section: Introductionmentioning

confidence: 99%

The Clinical Usefulness of Prostate-Specific Antigen (PSA) Level and Age-Specific PSA Reference Ranges for Detecting Prostate Cancer in Chinese

Huang²

2004

Urol Int

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Introduction: To determine the role of prostate-specific antigen (PSA) level and age-specific PSA reference ranges for detecting prostate cancer in Chinese. Material and Methods: We retrospectively reviewed the medical records of all 50- to 79-year-old men who had their first-time prostatic biopsy done at our institute between January 1998 and December 2000. We evaluated the effect on biopsy rate and cancer detection if the PSA cutoff was shifted from 4.0 ng/ml to the age-specific reference ranges. Also, we tried to develop age-adjusted PSA cutoffs for Chinese. Results: Among 1,236 men enrolled, 252 (20.4%) were diagnosed as prostate cancers. The positive predictive value was 22.2% for PSA >4.0 ng/ml. Using the traditional age-specific PSA reference ranges 134 (10.8%) biopsies could be avoided but five (1.98%) cancers would be missed. We proposed age-specific PSA reference ranges for Chinese as: 0–4.0 ng/ml for men in their 50s and 0–6.0 ng/ml for men between 60 and 79 years. Had we used these alternative cutoffs, 150 (12.1%) biopsies could be saved, of them 3 were cancers. Conclusions: The age-specific PSA reference ranges may help to avoid 12% of biopsies but 1.2% of prostate cancers would have gone undetected. Among population with low incidence of prostate cancer as Chinese, minimizing unnecessary biopsies might be more important issue than maximizing cancer detection rate.

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“…DRE, however, has a large influence in combination with PSA and age ranges on the probability of positive biopsy (51%) (20,21).…”

Section: Serum Markers and Digital Rectal Examinationmentioning

confidence: 99%