Opportunistic prostate‐specific antigen testing in Norwegian men: a public health challenge

Author:

Albertsen Peter C.1,Bjerner Lars Johan2,Pasovic Lara3,Müller Stig34,Fosså Sophie45,Carlsson Sigrid V.67,Oldenburg Jan48

Affiliation:

1. Department of Surgery (Urology) UConn Health Farmington CT USA

2. Department of Clinical Chemistry Fürst Laboratories Oslo Norway

3. Department of Urology Akershus University Hospital Lørenskog Norway

4. Medical Faculty University of Oslo Oslo Norway

5. Department of Oncology Oslo University Hospital Oslo Norway

6. Department of Surgery (Urology Service) and Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York NY USA

7. Sahlgrenska Academy at Gothenburg University Gothenburg Sweden

8. Department of Oncology Akershus University Hospital Lørenskog Norway

Abstract

ObjectiveTo describe age‐specific prostate‐specific antigen (PSA) distributions and resulting prostate cancer diagnoses that arise from population‐wide opportunistic PSA testing.Patients and MethodsOver 8 million PSA tests were performed on >1.4 million Norwegian men from 2000 to 2020. During this period 43 486 men were diagnosed with localised prostate cancer. Most of the PSA testing reflected opportunistic testing. Age‐specific PSA value distributions were constructed for men aged 45–75 years with and without prostate cancer.ResultsThe distributions of PSA values in men with and without prostate cancer widened with age and overlapped extensively from 3 to 7 ng/mL. Localised prostate cancer diagnoses increased 10‐fold from the age of 45 to 75 years. PSA testing identified intermediate‐ or high‐grade cancers in 21% (95% confidence interval [CI] 19–23%) of men aged 50–54 years and 42% (95% CI 41–43%) of men aged 70–74 years. Grade group (GG)1, GG2, GG3 and ≥GG4 constituted 49%, 31%, 10% and 10% of cancers identified at age 50–54 years and 26%, 26%, 18%, and 30% of cancers identified at age 70–74 years.ConclusionOpportunistic PSA testing increases with ageing and often generates values that cannot discriminate benign prostate enlargement from prostate cancer. A clinical cascade using additional imaging or serum tests is necessary to avoid negative biopsies and the overdiagnosis of indolent disease. The declining specificity of PSA testing with ageing poses a significant public health challenge especially among older men aged ≥70 years.

Publisher

Wiley

Subject

Urology

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3