Population-based assessment of prostate-specific antigen testing for prostate cancer in the elderly - Abstract

OBJECTIVES: To perform a population-based analysis to characterize the effect of prostate-specific antigen (PSA) testing on oncologic outcomes in men diagnosed with prostate cancer.

MATERIALS AND METHODS: We used the Surveillance, Epidemiology, and End Results-Medicare-linked data to identify 98,883 men diagnosed with prostate cancer from 1996 to 2007. We stratified frequency of PSA testing as none, 1 to 2, 3 to 5, and ≥6 tests in the 5 years before prostate cancer diagnosis. We used propensity scoring methods to assess the effect of frequency of PSA testing on likelihood of (1) metastases at diagnosis and (2) overall mortality and prostate cancer-specific mortality.

RESULTS: In adjusted analyses, the likelihood of being diagnosed with metastatic prostate cancer decreased with greater frequency of PSA testing (none, 10.6; 1-2, 8.3; 3-5, 3.7; and ≥6, 2.5 events per 100 person years, P< 0.001). Additionally, greater frequency of PSA testing was associated with improved overall survival and prostate cancer-specific survival (P< 0.001 for both).

CONCLUSIONS: Greater frequency of PSA testing in men 70 years of age or older in the 5 years before prostate cancer diagnosis is associated with lower likelihood of being diagnosed with metastatic prostate cancer and improved overall and prostate cancer-specific survival.

Written by:
Hu JC, Williams SB, Carter SC, Eggener SE, Prasad S, Chamie K, Trinh QD, Sun M, Nguyen PL, Lipsitz SR.   Are you the author?
Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA; 2Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX; Section of Urology, University of Chicago, Chicago, IL; Department of Urology, Medical University of South Carolina, Charleston, SC; Department of Urology, Brigham and Women׳s Hospital, Boston, MA; Cancer Prognostics and Health Outcomes Unit, Centre Hospitalier de l׳Université de Montréal, Montreal, Canada; Department of Radiation Oncology, Brigham and Women׳s Hospital, Boston, MA; Center for Surgery and Public Health, Brigham and Women׳s Hospital, Boston, MA.  

Reference: Urol Oncol. 2014 Jul 10. pii: S1078-1439(14)00209-9.
doi: 10.1016/j.urolonc.2014.06.003

PubMed Abstract
PMID: 25017694

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