Lane, J.A., Howson, J., Donovan, J.L. et al. (6 more authors) (2007) Detection of prostate cancer in unselected young men: prospective cohort nested within a randomised controlled trial. BMJ, 335 (7630). pp. 1139-1143. ISSN 0959-8146
Abstract
Objective: To investigate the feasibility of testing for prostate cancer and the prevalence and characteristics of the disease in unselected young men.
Design: Prospective cohort nested within a randomised controlled trial, with two years of follow-up.
Setting: Eight general practices in a UK city.
Participants: 1299 unselected men aged 45-49.
Intervention: Prostate biopsies for participants with a prostate specific antigen level of 1.5 ng/ml or more and the possibility of randomisation to three treatments for those with localised prostate cancer.
Main outcome measures: Uptake of testing for prostate specific antigen; positive predictive value of prostate specific antigen; and prevalence of prostate cancer, TNM disease stage, and histological grade (Gleason score 6-10). Results 442 of 1299 men agreed to be tested for prostate specific antigen (34%) and 54 (12%) had a raised level. The positive predictive value for prostate specific antigen was 21.3%. Ten cases of prostate cancer were detected (2.31/6) with eight having at least two positive results in biopsy cores and three showing perineural invasion. One tumour was of high volume (cT2c), Gleason score 7, with a positive result on digital rectal examination; nine tumours were cT1c, Gleason score 6, and eight had a negative result on digital rectal examination. Five of the nine eligible participants (55%) agreed to be randomised. No biochemical disease progression occurred in two years of follow-up.
Conclusions: Men younger than 50 will accept testing for prostate cancer but at a much tower rate than older men. Using an age based threshold of 1.5 ng/ml, the prevalence of prostate cancer was similar to that in older men (3.0 ng/ml threshold) and some cancers of potential clinical significance were found.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > The Medical School (Sheffield) |
Depositing User: | Repository Officer |
Date Deposited: | 03 Nov 2008 19:15 |
Last Modified: | 03 Nov 2008 19:15 |
Published Version: | http://dx.doi.org/10.1136/bmj.39381.436829.BE |
Status: | Published |
Publisher: | BMJ Publishing |
Refereed: | Yes |
Identification Number: | 10.1136/bmj.39381.436829.BE |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:4812 |