Screening for prostate cancer: are organized screening programs necessary?

Roobol, Monique J.

doi:10.21037/tau.2017.12.10

Cited by 12 publications

(7 citation statements)

References 40 publications

(34 reference statements)

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“…Therefore, obtained risk excess of prostate cancer in our study group could in part be explained by surveillance bias since patients with diabetes are under increased surveillance and are more likely to undergo additional medical examinations including prostate-specific antigen (PSA) testing. The use of PSA testing as an early detection tool may cause overdiagnosis or detection of indolent tumors [27].…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Site-Specific Cancer in People with Type 2 Diabetes: A National Cohort Study

Linkeviciute-Ulinskiene

Patašius

Zabulienė

et al. 2019

IJERPH

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A retrospective cohort design was used with the objective to evaluate cancer risk among people with type 2 diabetes mellitus (T2DM) in Lithuania. The cohort was established by identifying all patients with the first diagnosis of T2DM in the National Health Insurance Fund database during 2000-2012. Cancer cases were identified by record linkage with the Lithuanian Cancer Registry. Standardized incidence ratios (SIRs) were calculated. Of the 127,290 people that were included, 5959 cases of cancer in men and 6661 cancer cases in women with T2DM were observed. A statistically significant increase in risk for all cancer sites was observed in women, SIR 1.16 (95% CI 1.14-1.19), but not in men, SIR 1.00 (95% CI 0.98-1.03). Among males, a significant increase of liver (SIR 2.11, 95% CI 1.79-2.49]), pancreas (SIR 1.77, 95% CI 1.57-1.99), kidney (SIR 1.46 95% CI 1.31-1.62), thyroid (SIR 1.83, 95% CI 1.32-2.54), colorectal (SIR 1.23, 95% CI 1.14-1.31]), skin melanoma (SIR 1.40, 95% CI 1.11-1.76), and non-melanoma skin (SIR 1.14, 95% CI 1.05-1.23) cancer was observed. For females with T2DM, a significant increase in risk of cancer of the liver (SIR 1.45, 95% CI 1.17-1.79), pancreas (SIR 1.74, 95% CI 1.56-1.93), kidney (SIR = 1.43, 95% CI 1.28-1.60), thyroid (SIR = 1.40, 95% CI 1.22-1.62), breast (SIR = 1.24, 95% CI 1.17-1.31), and corpus uteri (SIR 2.07, 95% CI 1.93-2.21) was observed. In conclusion, people with T2DM in Lithuania had an increased risk of site-specific cancer.

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Section: Discussionmentioning

confidence: 99%

Increased Risk of Site-Specific Cancer in People with Type 2 Diabetes: A National Cohort Study

Linkeviciute-Ulinskiene

Patašius

Zabulienė

et al. 2019

IJERPH

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“…PSA testing has indeed increased PCa incidence rate while decreasing the related mortality. However, PSA mass screening remains one of the most controversial topic in the urological literature due to the risks of overdiagnosis and overtreatment of clinically insignificant PCa [3][4][5]. Currently, diagnosis of PCa is determined by histologic report of biopsy undertaken in case of clinical suspicion, high PSA level and/or abnormal digital rectal examination (DRE).…”

Section: Introductionmentioning

confidence: 99%

The role of multiparametric resonance and biopsy in prostate cancer detection: comparison with definitive histological report after laparoscopic/robotic radical prostatectomy

Rapisarda¹,

Bada

Crocetto

et al. 2020

Abdom Radiol

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Purpose Magnetic Resonance Imaging (MRI) targeted biopsy increases overall detection rates and decreases the risk of clinically insignificant PCa detection. The aim of this retrospective study is to compare concordance rates regarding side of lesion and Gleason Score at fusion targeted/systematic biopsy and MRI with the definitive histologic report of prostatectomy specimen. Methods 115 patients underwent multiparametric (mp) MRI and successively fusion targeted/systematic biopsy. 107 patients, with a positive biopsy for PCa, further underwent laparoscopic/robotic radical prostatectomy. We compared surgical histologic report with biopsy histologic report for side of lesion and Gleason Score. We further compared PIRADS score at mpMRI with Gleason Score of both histologic reports. Results Concordance rate for mpMRI lesion side was 74% compared to biopsy and 52.3% compared to surgical histologic report (p < 0.0001). Fusion targeted/systematic biopsy reported a concordance rate with surgical histologic report of 67.3% for side of the lesion, while Gleason Score was concordant for 73.6% for clinically significant cancer (Gleason Score ≥ 7) (p < 0.0001). PIRADS score ≥ 3 was further associated with clinically significant cancer at surgical histologic report in 92.4% of cases (p = 0.359). Conclusion Multiparametric MRI of the prostate reaches a good and improvable accuracy in the detection of suspicious PCa before biopsy. A combined approach of fusion targeted and systematic biopsy could further increase the overall accuracy in PCa diagnosis, especially in biopsy-naïve patients, reaching concordance rates with definitive histologic report up to 52.3% and 85.5%.

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“…Besides the tangible benefits of PSA testing, which appears to be small based on recent mortality data, the test may also cause unwanted harms, such as overdiagnosis or detection of indolent tumours,22 and as a consequence of overdiagnosis, overtreatment23 and reduction in life quality 24. Although PSA screening may be beneficial in an organised setting,25 the net effect of a higher PSA uptake at a population level could be negative due to side effects.…”

Section: Discussionmentioning

confidence: 99%

Prostate cancer incidence and mortality in the Baltic states, Belarus, the Russian Federation and Ukraine

et al. 2019

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BackgroundProstate cancer incidence varies internationally largely attributable to differences in prostate-specific antigen (PSA) use. The aim of this study was to provide the most recent detailed international epidemiological comparison of prostate cancer incidence and mortality in six north-eastern European countries (Belarus, Estonia, Latvia, Lithuania, the Russian Federation and Ukraine).MethodsThe number of incident prostate cancer cases was obtained from the countries national cancer registries. Prostate cancer mortality and corresponding population data were extracted from the WHO Mortality Database. Age-specific and age-standardised incidence and mortality rates were calculated (European Standard). The joinpoint regression model was used to provide an average annual percentage change and to detect points in time where significant changes in trends occurred. The observation period was between 13 (Ukraine) and 48 (Estonia) years regarding incidence and around 30 years regarding mortality.ResultsThe comparison of prostate cancer incidence in six European countries showed almost sixfold differences in the age-adjusted rates in most recent years with highest incidence rates in Lithuania and Estonia. Through the observation period, overall a continuous rise was seen in incidence in all countries and a continuous rise in mortality, with a stabilisation in Estonia and a decrease in Lithuania in recent years. Data limitations included a descriptive design using ecological data.ConclusionsA widespread use of PSA testing seems to be responsible for the changes in the epidemiology of the disease in north-eastern European countries. Substantial variation in the incidence of prostate cancer in the Baltic states suggests the possibility that PSA performance and utilisation spread have had a major influence on observed incidence trends, with a lack of effect on prostate cancer mortality.

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Screening for prostate cancer: are organized screening programs necessary?

Cited by 12 publications

References 40 publications

Increased Risk of Site-Specific Cancer in People with Type 2 Diabetes: A National Cohort Study

Increased Risk of Site-Specific Cancer in People with Type 2 Diabetes: A National Cohort Study

The role of multiparametric resonance and biopsy in prostate cancer detection: comparison with definitive histological report after laparoscopic/robotic radical prostatectomy

Prostate cancer incidence and mortality in the Baltic states, Belarus, the Russian Federation and Ukraine

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