PURPOSE: We determined modified Gleason grade of prostatic adenocarcinomas detected in the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial, to assess grade distribution and to compare modified Gleason grades of cancers detected in the intervention arm (organized annual screening) vs. those in the control arm (opportunistic screening).
MATERIALS AND METHODS: Modified Gleason grading was performed for 859 radical prostatectomy cases by a single urologic pathologist. The proportion of cases with high grade disease in screened vs. control arm was compared by logistic regression analysis.
RESULTS: A modified Gleason score of 5, 6, 7(3+4), 7(4+3), 8, 9, and 10 was assigned in 3.6%, 43.3%, 39%, 7.4%, 3.5%, 3.2%, and 0.1% of cases in the intervention arm, respectively. A modified Gleason score of 5, 6, 7(3+4), 7(4+3), 8, 9, and 10 was assigned in 3.0%, 35.7%, 46.4%, 7.1%, 5.4%, 1.9%, and 0.5% of cases in the control arm, respectively, after correction for high-grade disease over-sampling. High-grade modified Gleason score of 7 or greater was detected in 53% of cases from the intervention arm compared to 61.3% of cases from the control arm after correction (p =0.019). The median modified Gleason score was 7 (3+4) for both arms.
CONCLUSIONS: A significant percentage of cancers in both arms had a component of high grade disease. The modified Gleason grade of the prostate cancers detected by organized annual screening was slightly lower than the modified Gleason grade of prostate cancers detected by opportunistic screening, an expected consequence of more intensive screening.
Written by:
Humphrey PA, Hickey TP, Riley TL, Mabie JE, Bellinger A, Strother M, Andriole GL. Are you the author?
Division of Urology, Department of Surgery, Washington University School of Medicine, St. Louis; Department of Pathology and Immunology, Washington University School of Medicine, St. Louis; Information Management Services, Rockville, MD.
Reference: J Urol. 2014 Mar 1. pii: S0022-5347(14)00348-6.
doi: 10.1016/j.juro.2014.02.090
PubMed Abstract
PMID: 24594407
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