OBJECTIVES: To investigate whether prostate-specific antigen-based screening reduced the prostate cancer mortality rate in Yokosuka, Japan.
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METHODS: We carried out a cohort study, in which we compared clinical outcomes between patients detected by prostate-specific antigen-based screening (S group n = 524) versus those detected by other means (NS group n = 1044). Clinical and pathological factors were evaluated using Cox regression analyses and the Kaplan-Meier method.
RESULTS: A total of 1.5% (8/524) of patients in the S group and 6.7% (70/1044) of those in the NS group died from prostate cancer during follow up. A total of 8.0% (42/524) of patients in the S group and 11.4% (119/1044) in the NS group died from other causes. The 10-year cancer specific survival rates of the S and NS groups were 97% and 86%, respectively (P < 0.001). The median age was significantly lower in the S group than the NS group: 71 and 73 years, respectively (P < 0.001). The rate of Gleason score 8-10 was significantly lower in the S group than the NS group: 9.7% and 16.7%, respectively (P < 0.001). The rate of patients with metastasis or prostate-specific antigen 100 ng/mL or more was significantly lower in the S group than the NS group: 7.8% and 23.0%, respectively (P < 0.001). On multivariate analysis, Gleason score 8-10 compared with Gleason score 6 was independently associated with cancer-specific survival (hazard ratio 4.808, 95% confidence interval 1.044-22.14, P = 0.044).
CONCLUSIONS: Prostate-specific antigen-based population screening in Yokosuka City might help to reduce the prostate cancer mortality rate.
Sakai N, Taguri M, Kobayashi K, Noguchi S, Ikeda S, Koh H, Satomi Y, Furuhata A. Are you the author?
Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan; Department of Biostatistics and Epidemiology, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan; Department of Urology, Kinugasa Hospital, Yokosuka, Kanagawa, Japan; Department of Urology, Yokosuka City Uwamachi Hospital, Yokosuka, Kanagawa, Japan; Department of Urology, Satomi Jin-Hinyokika, Yokosuka, Kanagawa, Japan; Department of Urology, Furuhata Hinyokika Clinic, Yokosuka, Kanagawa, Japan.
Reference: Int J Urol. 2015 May 23. Epub ahead of print.