Prostate cancer screening in men aged 50–69 years (STHLM3): a prospective population-based diagnostic study

Grönberg, Henrik; Adolfsson, Jan; Aly, Markus; Nordström, Tobias; Wiklund, Peter; Brandberg, Yvonne; Thompson, James; Wiklund, Fredrik; Lindberg, Johan; Clements, Mark; Egevad, Lars; Eklund, Martin

doi:10.1016/s1470-2045(15)00361-7

Cited by 337 publications

(335 citation statements)

References 35 publications

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“…Various other biomarkers and protocols have been explored and have achieved some promising results. [8][9][10][11] After diagnosis, a crucially important issue is to assess aggressiveness of cancer, so as to discriminate indolent PCa from aggressive ones, enabling the doctors to discriminate patients suitable for active surveillance from those who need radical prostatectomy. 12 The Gleason score (GS) of prostate biopsy specimens diagnosed by pathologists is of crucial importance to assess aggressiveness of PCa; however, several studies revealed discrepancies of GS between biopsy specimens and the corresponding radical prostatectomy specimens.…”

Section: Introductionmentioning

confidence: 99%

Surface-enhanced Raman spectroscopy of serum accurately detects prostate cancer in patients with prostate-specific antigen levels of 4–10 ng/mL

Chen

Rong

Shao

et al. 2017

IJN

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The surface-enhanced Raman spectroscopy (SERS) of blood serum was investigated to differentiate between prostate cancer (PCa) and benign prostatic hyperplasia (BPH) in males with a prostate-specific antigen level of 4–10 ng/mL, so as to reduce unnecessary biopsies. A total of 240 SERS spectra from blood serum were acquired from 40 PCa subjects and 40 BPH subjects who had all received prostate biopsies and were given a pathological diagnosis. Multivariate statistical techniques, including principal component analysis (PCA) and linear discriminant analysis (LDA) diagnostic algorithms, were used to analyze the spectra data of serum from patients in control (CTR), PCa and BPH groups; results offered a sensitivity of 97.5%, a specificity of 100.0%, a precision of 100.0% and an accuracy of 99.2% for CTR; a sensitivity of 90.0%, a specificity of 97.5%, a precision of 94.7% and an accuracy of 98.3% for BPH; a sensitivity of 95.0%, a specificity of 93.8%, a precision of 88.4% and an accuracy of 94.2% for PCa. Similarly, this technique can significantly differentiate low- and high-risk PCa with an accuracy of 92.3%, a specificity of 95% and a sensitivity of 89.5%. The results suggest that analyzing blood serum using SERS combined with PCA–LDA diagnostic algorithms is a promising clinical tool for PCa diagnosis and assessment.

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Section: Introductionmentioning

confidence: 99%

Surface-enhanced Raman spectroscopy of serum accurately detects prostate cancer in patients with prostate-specific antigen levels of 4–10 ng/mL

Chen

Rong

Shao

et al. 2017

IJN

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“…PCa is one of the most common malignant tumors and a major public health problem, and its incidence is likely to increase as the population ages [40]. Because the specific molecular mechanisms of PCa remain unclear and current PCa screening methods cannot precisely differentiate malignant cancers from begin prostatic hyperplasia [41], it is necessary to find novel biomarkers for better screening and fast, accurate PCa diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Retinoic Acid Receptor Beta Promoter Methylation in Prostate Cancer: A Meta-Analysis

Dou

Zhou

Fan

et al. 2018

Cell Physiol Biochem

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Background/Aims: Retinoic acid receptor beta (RAR beta) is a retinoic acid receptor gene that has been shown to play key roles during multiple cancer processes, including cell proliferation, apoptosis, migration and invasion. Numerous studies have found that methylation of the RAR beta promoter contributed to the occurrence and development of malignant tumors. However, the connection between RAR beta promoter methylation and prostate cancer (PCa) remains unknown. This meta-analysis evaluated the clinical significance of RAR beta promoter methylation in PCa. Materials and Methods: We searched all published records relevant to RAR beta and PCa in a series of databases, including PubMed, Embase, Cochrane Library, ISI Web of Science and CNKI. The rates of RAR beta promoter methylation in the PCa and control groups (including benign prostatic hyperplasia and normal prostate tissues) were summarized. In addition, we evaluated the source region of available samples and the methods used to detect methylation. To compare the incidence and variation in RAR beta promoter methylation in PCa and non-PCa tissues, the odds ratio (OR) and 95% confidence interval (CI) were calculated accordingly. All the data were analyzed with the statistical software STATA 12.0. Results: Based on the inclusion and exclusion criteria, 15 articles assessing 1,339 samples were further analyzed. These data showed that the RAR beta promoter methylation rates in PCa tissues were significantly higher than the rates in the non-PCa group (OR=21.65, 95% CI: 9.27-50.57). Subgroup analysis according to the source region of samples showed that heterogeneity in Asia was small (I²=0.0%, P=0.430). Additional subgroup analysis based on the method used to detect RAR beta promoter methylation showed that the heterogeneity detected by MSP (methylation-specific PCR) was relatively small (I²=11.3%, P=0.343). Conclusion: Although studies reported different rates for RAR beta promoter methylation in PCa tissues, the total analysis demonstrated that RAR beta promoter methylation may be correlated with PCa carcinogenesis and that the RAR beta gene is particularly susceptible. Additional studies with sufficient data are essential to further evaluate the clinical features and prognostic utility of RAR beta promoter methylation in PCa.

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“…These harms could, however, be reduced by smarter screening using risk prediction tools to aid in the decision to have a PSA-test or to undergo a prostate biopsy (35). In addition, other biomarkers and MRI could be incorporated into the diagnostic pathway to secure the detection of potentially lethal PCa (36,37).…”

Section: Discussionmentioning

confidence: 99%

Can active surveillance really reduce the harms of overdiagnosing prostate cancer? A reflection of real life clinical practice in the PRIAS study

Drost¹,

Bangma²,

Kakehi³

et al. 2018

European Urology Supplements

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Background: Active surveillance (AS) for low-risk prostate cancer (PCa) appears to provide excellent longterm PCa-specific and overall survival. The choice for AS as initial treatment is mainly based on avoiding side effects from invasive treatment; but AS entails regular check-ups and the possibility of still having to switch or deciding to switch to invasive treatment. Here, we assessed the long-term follow-up data from AS in real life clinical practices.Methods: Data from the first 500 men, enrolled in PRIAS before July 2008 by 30 centers across 8 countries, were analyzed to provide long-term follow-up results. Men were advised to be regularly examined with prostate-specific antigen (PSA) tests, digital rectal examinations, and prostate biopsies. Men were advised to switch to invasive treatment if they had disease reclassification [Gleason score (GS) ≥3+4 on biopsy, more than two positive biopsy cores, a stage higher than cT2] or a PSA-doubling time of 0-3 years.We assessed time on AS, outcomes and reasons for discontinuing AS, and rates of potential unnecessary biopsies and treatments.Results: The median follow-up time was 6.5 years. During this period, 325 (65%) men discontinued after a median of 2.3 years and 121 (24%) men had no recent (>1 year) data-update after a median of 7.3 years. The remaining 54 (11%) men were confirmed to be still on AS. Most men discontinued based on protocol advice; 38% had other reasons. During follow-up, 838 biopsy sessions were performed of which 79% to 90% did not lead to reclassification, depending on the criteria. Of the 325 discontinued men, 112 subsequently underwent radical prostatectomy (RP), 126 underwent radiotherapy, 57 switched to watchful waiting (WW) or died, and 30 had another or unknown treatment. RP results were available of 99 men: 34% to 68%, depending on definition, had favorable outcomes; 50% of unfavorable the outcomes occurred in the first 2 years. Of the 30 (6%) men who died, 1 man died due to PCa.Conclusions: These data, reflecting real life clinical practice, show that more than half of men switched to invasive treatment within 2.3 years, indicating limitations to the extent in which AS is able to reduce the * All contributors to the data in this paper are listed in the Table S1. IntroductionSince the use of prostate specific antigen (PSA) testing, the majority of newly diagnosed prostate cancer (PCa) patients are considered to have low risk of progression (1). Although PSA screening leads to a PCa mortality reduction, overdiagnosis and overtreatment of these low-risk PCa patients are still a substantial concern (1-4). To prevent overtreatment, active surveillance (AS) is increasingly recognized as a favorable alternative to direct radical therapy for men with low-risk PCa (5-8). Considering all relevant data, the US Preventive Services Task Force (USPSTF) has recently proposed to endorse physicians to counsel men on PSA screening (9). This change in the USPSTF recommendation is heavily based on a modeling study which suggests that greater use of AS ...

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Prostate cancer screening in men aged 50–69 years (STHLM3): a prospective population-based diagnostic study

Cited by 337 publications

References 35 publications

Surface-enhanced Raman spectroscopy of serum accurately detects prostate cancer in patients with prostate-specific antigen levels of 4–10 ng/mL

Surface-enhanced Raman spectroscopy of serum accurately detects prostate cancer in patients with prostate-specific antigen levels of 4–10 ng/mL

Clinical Significance of Retinoic Acid Receptor Beta Promoter Methylation in Prostate Cancer: A Meta-Analysis

Can active surveillance really reduce the harms of overdiagnosing prostate cancer? A reflection of real life clinical practice in the PRIAS study

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Prostate cancer screening in men aged 50–69 years (STHLM3): a prospective population-based diagnostic study

Cited by 337 publications

References 35 publications

Surface-enhanced Raman spectroscopy of serum accurately detects prostate cancer in patients with prostate-specific antigen levels of 4&ndash;10 ng/mL

Surface-enhanced Raman spectroscopy of serum accurately detects prostate cancer in patients with prostate-specific antigen levels of 4&ndash;10 ng/mL

Clinical Significance of Retinoic Acid Receptor Beta Promoter Methylation in Prostate Cancer: A Meta-Analysis

Can active surveillance really reduce the harms of overdiagnosing prostate cancer? A reflection of real life clinical practice in the PRIAS study

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Surface-enhanced Raman spectroscopy of serum accurately detects prostate cancer in patients with prostate-specific antigen levels of 4–10 ng/mL

Surface-enhanced Raman spectroscopy of serum accurately detects prostate cancer in patients with prostate-specific antigen levels of 4–10 ng/mL