To investigate whether prostate-specific antigen-based screening reduced the prostate cancer mortality rate in Yokosuka, Japan.
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.
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).
Prostate-specific antigen-based population screening in Yokosuka City might help to reduce the prostate cancer mortality rate.
Int J Urol. 2015 May 23. doi: 10.1111/iju.12806. [Epub ahead of print]
Sakai N1, Taguri M2, Kobayashi K1, Noguchi S1, Ikeda S3, Koh H4, Satomi Y5, Furuhata A6.
1 Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan.
2 Department of Biostatistics and Epidemiology, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan.
3 Department of Urology, Kinugasa Hospital, Yokosuka, Kanagawa, Japan.
4 Department of Urology, Yokosuka City Uwamachi Hospital, Yokosuka, Kanagawa, Japan.
5 Department of Urology, Satomi Jin-Hinyokika, Yokosuka, Kanagawa, Japan.
6 Department of Urology, Furuhata Hinyokika Clinic, Yokosuka, Kanagawa, Japan.