Prediction of significant prostate cancer diagnosed 20 to 30 years later with a single measure of prostate-specific antigen at or before age 50.

Lilja, H; Cronin, A; Dahlin, A; Manjer, J; Nilsson, P; Eastham, J; Bjartell, A; Scardino, P; Ulmert, D; Vickers, A

Journal article

Prediction of significant prostate cancer diagnosed 20 to 30 years later with a single measure of prostate-specific antigen at or before age 50.

Abstract:: BACKGROUND: We previously reported that a single prostate-specific antigen (PSA) measured at ages 44-50 was highly predictive of subsequent prostate cancer diagnosis in an unscreened population. Here we report an additional 7 years of follow-up. This provides replication using an independent data set and allows estimates of the association between early PSA and subsequent advanced cancer (clinical stage ≥T3 or metastases at diagnosis). METHODS: Blood was collected from 21,277 men in a Swedish city (74% participation rate) during 1974-1986 at ages 33-50. Through 2006, prostate cancer was diagnosed in 1408 participants; we measured PSA in archived plasma for 1312 of these cases (93%) and for 3728 controls. RESULTS: At a median follow-up of 23 years, baseline PSA was strongly associated with subsequent prostate cancer (area under the curve, 0.72; 95% CI, 0.70-0.74; for advanced cancer, 0.75; 95% CI, 0.72-0.78). Associations between PSA and prostate cancer were virtually identical for the initial and replication data sets, with 81% of advanced cases (95% CI, 77%-86%) found in men with PSA above the median (0.63 ng/mL at ages 44-50). CONCLUSIONS: A single PSA at or before age 50 predicts advanced prostate cancer diagnosed up to 30 years later. Use of early PSA to stratify risk would allow a large group of low-risk men to be screened less often but increase frequency of testing on a more limited number of high-risk men. This is likely to improve the ratio of benefit to harm for screening.

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APA Style

Lilja, H., Cronin, A., Dahlin, A., Manjer, J., Nilsson, P., Eastham, J., Bjartell, A., Scardino, P., Ulmert, D., & Vickers, A. (2011). Prediction of significant prostate cancer diagnosed 20 to 30 years later with a single measure of prostate-specific antigen at or before age 50. Cancer, 117(6), 1210–1219.

MLA Style

Lilja, H, et al. “Prediction of Significant Prostate Cancer Diagnosed 20 to 30 Years Later with a Single Measure of Prostate-Specific Antigen at or before Age 50.” Cancer, vol. 117, no. 6, 2011, pp. 1210–19.

Chicago Style

Lilja, H, A Cronin, A Dahlin, et al. 2011. “Prediction of Significant Prostate Cancer Diagnosed 20 to 30 Years Later with a Single Measure of Prostate-Specific Antigen at or before Age 50.” Cancer 117 (6): 1210–19.
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