Eighteen-year follow-up of the Göteborg Randomized Population-based Prostate Cancer Screening Trial: effect of sociodemographic variables on participation, prostate cancer incidence and mortality

Hugosson, Jonas; Godtman, Rebecka Arnsrud; Carlsson, Sigrid; Aus, Gunnar; Bergdahl, Anna Grenabo; Lodding, Pär; Pihl, Carl‐Gustaf; Stranne, Johan; Holmberg, Erik; Lilja, Hans

doi:10.1080/21681805.2017.1411392

Cited by 68 publications

(67 citation statements)

References 24 publications

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“…27 Furthermore, data from the 18-year follow up of the G€ oteborg randomized population-based PCa screening trial showed that in standard care, when organized screening did not exist, less-educated men had higher PCa-mortality than more educated men. 28 In contrast, when screening was implemented in an organized way, PCa-mortality was not associated with education, suggesting that organized screening might diminish PCa-mortality differences across patients with various socioeconomic status. 28 Interestingly, health insurance coverage was not significantly associated with PSA testing, despite the notion of perceived barriers with cancer screening in patients who lack health insurance.…”

Section: Discussionmentioning

confidence: 98%

“…28 In contrast, when screening was implemented in an organized way, PCa-mortality was not associated with education, suggesting that organized screening might diminish PCa-mortality differences across patients with various socioeconomic status. 28 Interestingly, health insurance coverage was not significantly associated with PSA testing, despite the notion of perceived barriers with cancer screening in patients who lack health insurance.…”

Section: Discussionmentioning

confidence: 98%

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Predictors of prostate‐specific antigen testing in men aged ≥55 years: A cross‐sectional study based on patient‐reported outcomes

et al. 2020

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Objectives To examine the predictors of prostate‐specific antigen discussion with a physician and prostate‐specific antigen testing in men aged ≥55 years. Methods Utilizing the USA Health Information National Trends Survey, 4th Ed., a cross‐sectional study from 2011 to 2014 was carried out to analyze the factors predicting prostate‐specific antigen testing and discussion in men ≥55 years. Associations between each covariate and prostate‐specific antigen discussion/testing were determined. Multivariable logistic regression models were used to determine clinically relevant predictors of prostate‐specific antigen discussion/testing. Due to multiple comparisons, the Bonferroni correction was used. Results A total of 2731 men included in the Health Information National Trends Survey were analyzed. Several socioeconomic parameters were found to increase the likelihood of men aged ≥55 years to undergo prostate‐specific antigen testing: living with a spouse, a higher level of education (college graduate or above), a higher income (>$50 000 annually) and previous history of any cancer. In contrast, current smokers were less likely to undergo prostate‐specific antigen testing. Having a prostate‐specific antigen discussion with a physician was more likely for men surveyed in 2014, for men who were living with a spouse, who had a higher annual income (>$50 000 annually) and those with a history of any cancer. Conclusions Significant inequalities in prostate‐specific antigen testing and discussion exist among men in the USA, mainly driven by socioeconomic factors. Ideally, prostate‐specific antigen testing and discussion should be based on relevant clinical factors with a shared decision‐making approach for every man. Therefore, a better understanding of the socioeconomic factors influencing prostate‐specific antigen testing/discussions can inform strategies to reduce existing gaps in care.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Predictors of prostate‐specific antigen testing in men aged ≥55 years: A cross‐sectional study based on patient‐reported outcomes

et al. 2020

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“…Notice that a PSA cut-off value of 2.5 ng/mL has been recently recommended by the National Comprehensive Cancer Network 8 in the United States and the Goteborg trial. 9 This value must be compared with the PSA cut-off value (2.1 ng/mL) we obtained for a small tumor volume. A strong correlation between preoperative total PSA and tumor volume (V T ) was found by Carvalhal et-al.…”

Section: Discussionmentioning

confidence: 99%

<p>A New Interpretation of the Standard PSA-Test</p>

Esteban¹,

Almodovar-Abreu²

2020

RRU

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Background: In Puerto Rico, prostate cancer (PC) has the highest incidence and level of mortality. PC screening is performed using the standard prostatic-specific antigen (PSA) test with a cut-off value of 4.0 ng/mL. However, the standard PSA test is very controversial because it is subject to false positives and negatives. Purpose: To establish a new interpretation of the standard PSA test based on the strong correlation between total serum PSA and tumor volume. Patients and Methods: A PSA database of 21,980 Puerto Rican men (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) with proven PC was provided by the Puerto Rico Cancer Center Register (PRCCR). A statistical analysis was conducted for the entire PC population divided into two categories i) age and PSA ranges and ii) diagnostic year, age ranges, and PSA ranges. The weighted first percentiles of the PSA ranges were used to define three PSA cut-off values related to small, intermediate, and large tumor volumes. Further, three baseline PSA weighted median values were calculated to enable better prognosis of PC. Results: Three PSA cut-off values of 2.1 ng/mL, 6 ng/mL, and 10.5 ng/mL were found related to small (1.0 cc), intermediate (2.8 cc), and large (5.0 cc) PC tumor volumes, respectively. PSA values greater than the weighted median values of 3.1 ng/mL, 7 ng/mL, were associated with increased risks of tumors growing from small to intermediate and from intermediate to large size, respectively. A PSA value greater than 14.1 ng/mL was related to metastasis. Conclusion: In this research, we have found a new interpretation of the PSA test based on PSA cut-off values correlated to small, intermediate, and large prostate cancer tumor volumes. The set of these results together with the weighted PSA median values enhance the usefulness of the standard PSA test and provide a tool for a better decision-making and treatment.

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“…Recently, the 18-year follow-up study from the Goteborg randomized control trial, one center of the ERSPC trial, showed a large and statistically significant relative prostate cancer mortality reduction (RR = 0.31) for the attendees in this age group. 8 Similarly, two other recent studies indicated a possible benefit of screening for this age group. 12,13 Although the overall result reported from the CAP (Cluster Randomized Trial of PSA Testing for Prostate Cancer) trial was insignificant, the highest prostate cancer mortality reduction was seen in this age group.…”

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confidence: 87%

Assessment of harms, benefits, and cost‐effectiveness of prostate cancer screening: A micro‐simulation study of 230 scenarios

et al. 2020

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The incidence of prostate cancer has increased in most European countries, whereas prostate cancer mortality rates have declined. 1,2 Most Western European countries have experienced a sharp rise in the incidence of prostate cancer. The observed trend change in the incidence and mortality of prostate cancer may be partly related to opportunistic prostate-specific antigen (PSA) screening and advances in prostate cancer treatment and diagnostic procedures. 3 However, this progress is usually accompanied by a high risk of overdiagnosis. Various studies indicated that opportunistic PSA testing is less efficient and associated with a higher risk of overdiagnosis compared to organized screening. 4,5 An

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Eighteen-year follow-up of the Göteborg Randomized Population-based Prostate Cancer Screening Trial: effect of sociodemographic variables on participation, prostate cancer incidence and mortality

Abstract: These data corroborate previous findings that systematic PSA screening reduces PC mortality and suggest that systematic screening may reduce sociodemographic inequality in PC mortality.

Cited by 68 publications

References 24 publications

Predictors of prostate‐specific antigen testing in men aged ≥55 years: A cross‐sectional study based on patient‐reported outcomes

Predictors of prostate‐specific antigen testing in men aged ≥55 years: A cross‐sectional study based on patient‐reported outcomes

<p>A New Interpretation of the Standard PSA-Test</p>

Assessment of harms, benefits, and cost‐effectiveness of prostate cancer screening: A micro‐simulation study of 230 scenarios

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