ATLANTA, GA USA (PRESS RELEASE) - May 21, 2012 - Three new studies examining prostate-specific antigen (PSA) screenings and prostate cancer risk will be presented at the 107th Annual Scientific Meeting of the American Urological Association (AUA).
The studies were presented to reporters during special press conferences at the Georgia World Congress Center, Atlanta, GA on Monday, May 21 at 9:00 a.m., 9:30 a.m., and 10:00 a.m., respectively.
“While the debate surrounding PSA testing continues, history shows us that cancer screening can save lives,” said AUA spokesperson Christopher Amling, MD. “Determining how to best utilize the PSA test will help physicians and the men they treat make informed decisions that can lead to better health outcomes.”
What Will Happen if We Don’t Screen for Prostate Cancer? A 10-Year Analysis of Metastatic Prostate Cancer as an Initial Presentation in an Underserved Population (#1454): Patients of lower socioeconomic status as well as those originating from third world countries are less likely to seek medical attention or undergo cancer screening. Therefore, these patients usually present to a physician when they develop symptoms of locally advanced and/or metastatic disease. Considering recent controversies regarding PSA screening, researchers from SUNY Downstate in Brooklyn, NY sought to identify patients who presented with metastatic prostate cancer to identify those who would suffer if PSA screening was eliminated. Study investigators used a prospectively maintained androgen deprivation therapy database from an inner city hospital and identified 148 individuals meeting the study criteria. Median age at diagnosis, Gleason score and metastatic distribution were determined, while survival was analyzed using Kaplan Meier probability curves.
Results show the median age of presentation was 69 with a median Gleason sum of 8 on prostate biopsy. Of those patients who underwent radiographic imaging, 45% (50/111) had lymphadenopathy suspicious for metastasis, 19% (14/75) had masses suspicious for visceral metastases and 4% (3/75) had evidence of local progression/invasion. The median time for rise of PSA after nadir was 228.5 days. The median survival was found to be 4.2 years with a 2 and 5- year cancer specific survival of 68% and 39%, respectively.
Personalized PSA Testing Using Genetic Variants Can Possibly Decrease the Number of Prostate Biopsies (#1209): A personalized PSA value can be used to prevent unnecessary biopsies and improve the clinical performance characteristics of PSA, according to researchers from Chicago, IL. Study investigators studied 4 genetic variants associated with PSA levels (rs2736098, rs10788160, rs11067228, and rs17632542) from 964 healthy Caucasian volunteers. PSA values adjusted for genotype were calculated and weighted by dividing PSA values by their combined genetic risk. Statistical analyses were then used to compare the percentage of men who would meet commonly-used PSA thresholds (>2.5 ng/ml or >4.0 ng/ml).
Researchers first determined the adjusted PSA for hypothetical men with genotypes for a variable number of PSA genetic variants (ranging from 0-4) and a PSA of 2.5ng/ml. When genetic correction for the 4 genetic variants was applied to their actual cohort of healthy volunteers, significantly fewer men would be recommended to have a prostate biopsy. Using a 2.5 or 4.0 ng/ml as the biopsy threshold, genetic PSA correction would lead to a 15% and 20% relative reduction in potentially unnecessary biopsies.
Young Men (Ages 40-49) With a Single Baseline PSA Below 1.0 Ng/Ml Are at a Very Low 10-15 Year Risk of Prostate Cancer (#1219): Seventy-five percent of men could potentially safely avoid annual PSA screening for an additional 10 years if their baseline PSA falls in the lowest 75 percentile, according to researchers from the Mayo Clinic in Rochester, MN. Since 1990, a random sample of 268 men between 40-49 years old has been followed prospectively for prostate outcomes.
Results show that for men with a baseline PSA below 1.0 ng/ml, the 10-year estimate of low risk vs. intermediate/high risk prostate cancer (CaP) was 0.5% (95% CI 0-1.3%) and 0% respectively. The 15-year estimate of low risk vs. intermediate/high risk CaP was 2.7% (95% CI 0-5.3%) and 0, respectively. Conversely, a baseline PSA above or equal to 1.0 ng/mL resulted in a 9.5% and 12.8% risk of CaP diagnosis at 10 and 15 years respectively (HR 5.3 95% CI 2.0-15.1, with PSA <1.0 ng/ml as the referent). In this cohort, no man with a baseline PSA below 1.0 ng/ml between the ages of 40-49 developed an intermediate or high risk cancer with nearly 20 years of follow-up, while the men with low PSAs were also very unlikely to develop a low risk prostate cancer.
About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 18,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health policy.
American Urological Association
