Prostate specific antigen patterns in US and European populations: comparison of six diverse cohorts.

OBJECTIVE - To determine whether there are differences in prostate specific antigen (PSA) at diagnosis or changes in PSA between US and European populations of men with and without prostate cancer.

SUBJECTS AND METHODS - Repeated measures of PSA from six clinically and geographically diverse patient cohorts: two cohorts of men with PSA-detected prostate cancer, two cohorts with clinically-detected prostate cancer and two cohorts of men without prostate cancer.

Using multilevel models, average PSA at diagnosis and PSA change over time were compared between populations.

RESULTS - Annual percentage PSA change of 4-5% was similar between men without cancer and men with PSA-detected cancer. PSA at diagnosis was 1. 7ng/ml lower in a US cohort of PSA-detected men (95% CI 1. 3-2. 0ng/ml), compared to a PSA-detected UK cohort, but there was no evidence for a different rate of PSA change between these populations.

CONCLUSIONS - PSA changes over time are similar in UK and US men diagnosed through PSA testing and even in men without prostate cancer. Further development of PSA models to monitor men on active surveillance should be undertaken in order to take advantage of these similarities. We found no evidence that guidelines for using PSA to monitor men cannot be passed between US and European studies. This article is protected by copyright. All rights reserved.

BJU international. 2016 Jan 22 [Epub ahead of print]

Andrew J Simpkin, Jenny L Donovan, Kate Tilling, J Athene Lane, Richard M Martin, Peter C Albertsen, Anna Bill-Axelson, H Ballentine Carter, Ruud Bosch, Luigi Ferrucci, Freddie C Hamdy, Lars Holmberg, E Jeffrey Metter, David E Neal, Christopher C Parker, Chris Metcalfe

School of Social and Community Medicine, University of Bristol, Bristol, UK. , School of Social and Community Medicine, University of Bristol, Bristol, UK. , School of Social and Community Medicine, University of Bristol, Bristol, UK. , School of Social and Community Medicine, University of Bristol, Bristol, UK. , School of Social and Community Medicine, University of Bristol, Bristol, UK. , Division of Urology, UConn Health Center, University of Connecticut, USA. , Institution of Surgical Sciences, Department of Urology, Uppsala University, Sweden. , Department of Urology, Johns Hopkins School of Medicine, Baltimore, USA. , Department of Urology, University Medical Centre Utrecht, Utrecht, The Netherlands. , National Institute on Aging, National Institutes of Health, Baltimore, USA. , Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK. , King's College London Faculty of Life Sciences & Medicine, London, UK. , Department of Neurology, University of Tennessee Health Science Center, Memphis, USA. , Department of Oncology, University of Cambridge, Cambridge, UK. , Academic Urology Unit, Institute of Cancer Research, Royal Marsden Hospital, London, UK. , School of Social and Community Medicine, University of Bristol, Bristol, UK.

PubMed

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