The feasibility and results of a population-based approach to evaluating prostate-specific antigen screening for prostate cancer in men with a raised familial risk

Abstract

The feasibility of a population-based evaluation of screening for prostate cancer in men with a raised familial risk was investigated by studying reasons for non-participation and uptake rates according to postal recruitment and clinic contact. The levels of prostatespecific antigen (PSA) and the positive predictive values (PPV) for cancer in men referred with a raised PSA and in those biopsied were analysed. First-degree male relatives (FDRs) were identified through index cases (ICs): patients living in two regions of England and diagnosed with prostate cancer at age p65 years from 1998 to 2004. First-degree relatives were eligible if they were aged 45 -69 years, living in the UK and had no prior diagnosis of prostate cancer. Postal recruitment was low (45 of 1687 ICs agreed to their FDR being contacted: 2.7%) but this was partly due to ICs not having eligible FDRs. A third of ICs in clinic had eligible FDRs and 49% (192 out of 389) agreed to their FDR(s) being contacted. Of 220 eligible FDRs who initially consented, 170 (77.3%) had a new PSA test taken and 32 (14.5%) provided a previous PSA result. Among the 170 PSA tests, 10% (17) were X4 ng ml À1 and 13.5% (23) tests above the age-related cutoffs. In 21 men referred, five were diagnosed with prostate cancer (PPV 24%; 95% CI 8, 47). To study further the effects of screening, patients with a raised familial risk should be counselled in clinic about screening of relatives and data routinely recorded so that the effects of screening on high-risk groups can be studied.

Targeted prostate cancer screening in men with mutations in BRCA1 and BRCA2 detects aggressive prostate cancer: preliminary analysis of the results of the IMPACT study

“…The observed recruitment rates were higher than reported in two large population prostate screening studies, which described recruitment rates as low as 11%, although this may be a result of it being possible to check eligibility before approaching patients in the present study, whereas this was not always the case in the previous studies [36,37]. In line with the results reported in the present study, the ERSPC reported an uptake rate of 39.5% [38].…”

Feasibility of familial PSA screening: psychosocial issues and screening adherence

“…The recruitment of FDRs into the present study followed on from their recruitment into a linked PSA FSFS (see Melia et al, 2006). For the purpose of the study, index cases (ICs) were contacted who had given details of their FDRs to the FSFS.…”

Prostate Cancer Early Detection Program Recruitment Methods and Show Rates in Men at High Risk

“…While this study found that older age, higher socioeconomic status, and having a family history of PCA were predictors of PSA testing, this study was not based on a prospective screening population of high-risk men, a more motivated group of men seeking screening. Melia et al evaluated recruitment of PCA patients through postal recruitment and recruitment through clinics to obtain permission to contact their first-degree relatives for PCA screening in England 8. While marital status was correlated with higher rates of PCA screening in first-degree relatives of PCA patients in this study, no other participant characteristics were analyzed with respect to recruitment method.…”