Variation of prostate-specific antigen value in men and risk of high-grade prostate cancer: Analysis of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial study - Abstract

OBJECTIVE: To investigate variations in prostate-specific antigen (PSA) levels among men with an initial normal PSA level in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial study.

METHODS: Data were extracted from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial study data set on all men in the interventional arm, with 2 tests performed in a period of < 2 years and with an initial result of the first test < 4 ng/mL. The range of variation between first and second tests was computed. Risks of cancer stratified on Gleason score were computed using logistic regression.

RESULTS: A total of 31,286 men had 2 PSA tests within 2 years and with an initial value < 4 ng/mL. From the first to the second test, the median variation of PSA levels was 3.4% (interquartile range, -15% to +26%). The variation in PSA value was not associated with the delay between the first and the second test (P = .36), age (P = .16), body mass index (P = .41), and race (P = .12). A total of 2,781 prostate cancers were diagnosed during follow-up. Adjusting for age and initial PSA level, the risk of prostate cancer increased linearly with increasing PSA level at the second test, with an odds ratio of 1.079 (95% confidence interval, 1.058-1.101) for each percent increase in PSA level. However, the variation in PSA was not associated with a higher Gleason score (P = .95 for level variations in cancer of Gleason score < 7 vs ≥7).

CONCLUSION:Although an increase in PSA level over time is associated with increased risk of prostate cancer, this association is not related to more aggressive tumors.

Written by:
Boniol M, Autier P, Perrin P, Boyle P.   Are you the author?
University of Strathclyde Institute of Global Public Health at iPRI, Lyon, France; International Prevention Research Institute (iPRI), Lyon, France; Department of Urology, CHU Lyon-Sud, Pierre-Benite, France.  

Reference: Urology. 2015 May;85(5):1117-22.
doi: 10.1016/j.urology.2015.02.013

PubMed Abstract
PMID: 25917734 Prostate Cancer Section