The effect of start and stop age at screening on the risk of being diagnosed with prostate cancer.

The aim of this study was to investigate the effect of age and number of screens on the risk of prostate cancer (PCa) diagnosis.

The Göteborg randomized population-based PCa screening trial has, since 1995, invited men biennially for prostate-specific antigen (PSA)-testing, until the upper age limit 70 years.

Men with a PSA-level above the threshold ≥2. 5 ng/ml were recommended further work-up including 10-core biopsy (sextant before 2009). The present study comprises 9,065 men born 1930-43 (1944 excluded due to different screening algorithm). Complete attendees were defined as men who accepted all screening invitations (maximum 3-9 invitations). Cumulative incidence of PCa was calculated using standard methods.

Of the 3,488 (38%) complete attendees, 667 were diagnosed with PCa (follow-up 1995-30 Jun 2014). At the age 70, there was no significant difference in PCa risk between those who started screening at the age of 52 (9 screens), 55 (7 screens) or 60 (5 screens) years. However, the cumulative risk of PCa diagnosis increased dramatically with age and was 7. 9% at age 60, 15% at age 65 and 21% at age 70, for men who had been screened ≥4 times.

There was no clear association between risk of PCa and the number of screens. Starting screening at an early age appears to advance the time of PCa diagnosis but does not seem to increase the risk of being diagnosed with the disease. Age at termination of screening is strongly associated with the risk of being diagnosed with PCa.

The Journal of urology. 2015 Dec 08 [Epub ahead of print]

Rebecka Arnsrud Godtman, Sigrid Carlsson, Erik Holmberg, Johan Stranne, Jonas Hugosson

Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Göteborg, Sahlgrenska University Hospital, Göteborg, Sweden. Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Göteborg, Göteborg, Sweden; Department of Surgery (Urology service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA. , Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Göteborg, Göteborg, Sweden. , Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Göteborg, Sahlgrenska University Hospital, Göteborg, Sweden. , Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Göteborg, Göteborg, Sweden.

PubMed