Skip to main content
SpringerLink
Log in

Prostate Cancer Screening: Navigating the Controversy

  • Chapter
  • First Online:
Prostate Cancer Diagnosis

Part of the book series: Current Clinical Urology ((CCU))

Abstract

Despite advances in diagnosis, treatment, and patient outcomes, prostate cancer remains an important public health problem. In the United States in 2010, an estimated 217,730 new cases of prostate cancer were diagnosed and 32,050 men died as a result of this disease (Jemal et al. CA Cancer J Clin 60(5): 277–300, 2010). Prostate cancer is the second leading cause of cancer death in US men. The natural history of prostate cancer is remarkably heterogeneous, ranging from clinically silent tumors never destined to impact a patient to aggressive, metastatic cancers which cause considerable morbidity and patient death. A recent autopsy study revealed a prostate cancer prevalence of 1 in 3 for men aged 60–69 (Yin et al. J Urol 179(3): 892–5, 2008). However, the risk of death from prostate cancer is only 3.4 %, highlighting the variable natural history of prostate cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Jemal A, et al. Cancer statistics, 2010. CA Cancer J Clin. 2010;60(5):277–300.

    Article  PubMed  Google Scholar 

  2. Yin M, et al. Prevalence of incidental prostate cancer in the general population: a study of healthy organ donors. J Urol. 2008;179(3):892–5. discussion 895.

    Article  PubMed  Google Scholar 

  3. Mariotto AB, et al. Projections of the cost of cancer care in the United States: 2010–2020. J Natl Cancer Inst. 2011;103(2):117–28.

    Article  PubMed  Google Scholar 

  4. Zhang Y, et al. Understanding prostate cancer spending growth among Medicare beneficiaries. Urology. 2011;77(2):326–31.

    Article  PubMed  Google Scholar 

  5. A.U. Association. Early detection of prostate cancer and use of transrectal ultrasound. In: American Urological Association 1992 policy statement book. Baltimore: LWW; 1992.

    Google Scholar 

  6. Mettlin C, et al. Defining and updating the American Cancer Society guidelines for the cancer-related checkup: prostate and endometrial cancers. CA Cancer J Clin. 1993;43(1):42–6.

    Article  PubMed  CAS  Google Scholar 

  7. Schroder FH, et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med. 2009;360(13):1320–8.

    Article  PubMed  Google Scholar 

  8. Jhaveri FM, et al. Declining rates of extracapsular extension after radical prostatectomy: evidence for continued stage migration. J Clin Oncol. 1999;17(10):3167–72.

    PubMed  CAS  Google Scholar 

  9. Nam RK, et al. Increasing hospital admission rates for urological complications after transrectal ultrasound guided prostate biopsy. J Urol. 2010;183(3):963–8.

    Article  PubMed  Google Scholar 

  10. Childe C. The control of a scourge, or how cancer is curable. New York: E.P. Dutton; 1907.

    Google Scholar 

  11. Mettlin C, et al. Characteristics of prostate cancer detected in the American Cancer Society-National Prostate Cancer Detection Project. J Urol. 1994;152 (5 Pt 2):1737–40.

    PubMed  CAS  Google Scholar 

  12. Catalona WJ, et al. Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a ­multicenter clinical trial of 6,630 men. J Urol. 1994;151(5):1283–90.

    PubMed  CAS  Google Scholar 

  13. Etzioni R, et al. Impact of PSA screening on the incidence of advanced stage prostate cancer in the United States: a surveillance modeling approach. Med Decis Making. 2008;28(3):323–31.

    Article  PubMed  Google Scholar 

  14. Stamey TA, et al. Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med. 1987;317(15):909–16.

    Article  PubMed  CAS  Google Scholar 

  15. Jacobsen SJ, et al. Incidence of prostate cancer diagnosis in the eras before and after serum prostate-specific antigen testing. JAMA. 1995;274(18): 1445–9.

    Article  PubMed  CAS  Google Scholar 

  16. Ablin RJ, et al. Precipitating antigens of the normal human prostate. J Reprod Fertil. 1970;22(3):573–4.

    Article  PubMed  CAS  Google Scholar 

  17. Nadji M, et al. Prostatic-specific antigen: an immunohistologic marker for prostatic neoplasms. Cancer. 1981;48(5):1229–32.

    Article  PubMed  CAS  Google Scholar 

  18. Seamonds B, et al. Evaluation of prostate-specific antigen and prostatic acid phosphatase as prostate cancer markers. Urology. 1986;28(6):472–9.

    Article  PubMed  CAS  Google Scholar 

  19. Cooner WH, et al. Prostate cancer detection in a clinical urological practice by ultrasonography, digital rectal examination and prostate specific antigen. J Urol. 1990;143(6):1146–52. discussion 1152–4.

    PubMed  CAS  Google Scholar 

  20. Catalona WJ, et al. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med. 1991;324(17):1156–61.

    Article  PubMed  CAS  Google Scholar 

  21. Brawer MK, et al. Screening for prostatic carcinoma with prostate specific antigen. J Urol. 1992;147(3 Pt 2):841–5.

    PubMed  CAS  Google Scholar 

  22. Brawer MK, et al. Screening for prostatic carcinoma with prostate specific antigen: results of the second year. J Urol. 1993;150(1):106–9.

    PubMed  CAS  Google Scholar 

  23. Potosky AL, et al. The role of increasing detection in the rising incidence of prostate cancer. JAMA. 1995;273(7):548–52.

    Article  PubMed  CAS  Google Scholar 

  24. Thompson IM, et al. Operating characteristics of prostate-specific antigen in men with an initial PSA level of 3.0 ng/ml or lower. JAMA. 2005;294(1): 66–70.

    Article  PubMed  CAS  Google Scholar 

  25. Punglia RS, et al. Effect of verification bias on screening for prostate cancer by measurement of prostate-specific antigen. N Engl J Med. 2003;349(4):335–42.

    Article  PubMed  Google Scholar 

  26. Ransohoff DF, Feinstein AR. Problems of spectrum and bias in evaluating the efficacy of diagnostic tests. N Engl J Med. 1978;299(17):926–30.

    Article  PubMed  CAS  Google Scholar 

  27. Carter HB, et al. Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease. JAMA. 1992;267(16):2215–20.

    Article  PubMed  CAS  Google Scholar 

  28. Oesterling JE. Age-specific reference ranges for serum PSA. N Engl J Med. 1996;335(5):345–6.

    Article  PubMed  CAS  Google Scholar 

  29. Catalona WJ, et al. Selection of optimal prostate specific antigen cutoffs for early detection of prostate cancer: receiver operating characteristic curves. J Urol. 1994;152(6 Pt 1):2037–42.

    PubMed  CAS  Google Scholar 

  30. Carter HB, et al. Estimation of prostatic growth using serial prostate-specific antigen measurements in men with and without prostate disease. Cancer Res. 1992;52(12):3323–8.

    PubMed  CAS  Google Scholar 

  31. Smith DS, Catalona WJ. Rate of change in serum prostate specific antigen levels as a method for prostate cancer detection. J Urol. 1994;152(4):1163–7.

    PubMed  CAS  Google Scholar 

  32. Carter HB, et al. Prostate-specific antigen variability in men without prostate cancer: effect of sampling interval on prostate-specific antigen velocity. Urology. 1995;45(4):591–6.

    Article  PubMed  CAS  Google Scholar 

  33. Carter HB, et al. Detection of life-threatening prostate cancer with prostate-specific antigen velocity during a window of curability. J Natl Cancer Inst. 2006; 98(21):1521–7.

    Article  PubMed  Google Scholar 

  34. Zlotta AR, et al. Prostate specific antigen density of the transition zone for predicting pathological stage of localized prostate cancer in patients with serum prostate specific antigen less than 10 ng/ml. J Urol. 1998;160(6 Pt 1):2089–95.

    PubMed  CAS  Google Scholar 

  35. Kang SH, et al. Prostate-specific antigen adjusted for the transition zone volume as a second screening test: a prospective study of 248 cases. Int J Urol. 2006;13(7):910–4.

    Article  PubMed  Google Scholar 

  36. Jung K, et al. Ratio of free-to-total prostate specific antigen in serum cannot distinguish patients with prostate cancer from those with chronic inflammation of the prostate. J Urol. 1998;159(5):1595–8.

    Article  PubMed  CAS  Google Scholar 

  37. Walz J, et al. Percent free prostate-specific antigen (PSA) is an accurate predictor of prostate cancer risk in men with serum PSA 2.5 ng/mL and lower. Cancer. 2008;113(10):2695–703.

    Article  PubMed  CAS  Google Scholar 

  38. Mikolajczyk SD, Rittenhouse HG. Pro PSA: a more cancer specific form of prostate specific antigen for the early detection of prostate cancer. Keio J Med. 2003;52(2):86–91.

    Article  PubMed  Google Scholar 

  39. Catalona WJ, et al. Serum pro prostate specific antigen improves cancer detection compared to free and complexed prostate specific antigen in men with prostate specific antigen 2 to 4 ng/ml. J Urol. 2003;170(6 Pt 1):2181–5.

    Article  PubMed  CAS  Google Scholar 

  40. Thompson IM, et al. Assessing prostate cancer risk: results from the Prostate Cancer Prevention Trial. J Natl Cancer Inst. 2006;98(8):529–34.

    Article  PubMed  Google Scholar 

  41. Vickers AJ, et al. The relationship between prostate-specific antigen and prostate cancer risk: the Prostate Biopsy Collaborative Group. Clin Cancer Res. 2010;16(17):4374–81.

    Article  PubMed  CAS  Google Scholar 

  42. Draisma G, et al. Lead time and overdiagnosis in prostate-specific antigen screening: importance of methods and context. J Natl Cancer Inst. 2009;101(6):374–83.

    Article  PubMed  Google Scholar 

  43. Welch HG, Albertsen PC. Prostate cancer diagnosis and treatment after the introduction of prostate-specific antigen screening: 1986–2005. J Natl Cancer Inst. 2009;101(19):1325–9.

    Article  PubMed  Google Scholar 

  44. Finne P, et al. Lead-time in the European randomised study of screening for prostate cancer. Eur J Cancer. 2010;46(17):3102–8.

    Article  PubMed  Google Scholar 

  45. Thompson IM, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med. 2003;349(3):215–24.

    Article  PubMed  CAS  Google Scholar 

  46. Thompson IM, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level  <  or =4.0 ng per milliliter [see comment][erratum appears in N Engl J Med. 2004 Sep 30;351(14):1470]. N Engl J Med. 2004;350(22):2239–46.

    Article  PubMed  CAS  Google Scholar 

  47. Sirovich BE, Schwartz LM, Woloshin S. Screening men for prostate and colorectal cancer in the United States: does practice reflect the evidence? JAMA. 2003;289(11):1414–20.

    Article  PubMed  Google Scholar 

  48. Thompson IM, et al. Operating characteristics of prostate-specific antigen in men with an initial PSA level of 3.0 ng/ml or lower. JAMA. 2005;294(1): 66–70.

    Article  PubMed  CAS  Google Scholar 

  49. Roobol MJ, et al. Prostate cancer mortality reduction by prostate-specific antigen-based screening adjusted for nonattendance and contamination in the European Randomised Study of Screening for Prostate Cancer (ERSPC). Eur Urol. 2009;56(4):584–91.

    Article  PubMed  Google Scholar 

  50. Hugosson J, et al. Mortality results from the Goteborg randomised population-based prostate-cancer screening trial. Lancet Oncol. 2010;11(8):725–32.

    Article  PubMed  Google Scholar 

  51. Loeb S, et al. What is the true number needed to screen and treat to save a life with prostate-specific antigen testing? J Clin Oncol. 2011;29(4):464–7.

    Article  PubMed  Google Scholar 

  52. Nelen V, et al. Interval cancers in the Antwerp European randomised study of screening for prostate cancer study, using a 6 year screening interval. Eur J Cancer. 2010;46(17):3090–4.

    Article  PubMed  Google Scholar 

  53. Andriole GL, et al. Mortality results from a randomized prostate-cancer screening trial. N Engl J Med. 2009;360(13):1310–9.

    Article  PubMed  CAS  Google Scholar 

  54. Efstathiou JA, et al. Cardiovascular mortality after androgen deprivation therapy for locally advanced prostate cancer: RTOG 85-31. J Clin Oncol. 2009;27(1):92–9.

    Article  PubMed  Google Scholar 

  55. Carlsson S, et al. The excess burden of side-effects from treatment in men allocated to screening for prostate cancer. The Goteborg randomised population-based prostate cancer screening trial. Eur J Cancer. 2011;47(4):545–53.

    Article  PubMed  Google Scholar 

  56. Bussemakers MJ, et al. DD3: a new prostate-specific gene, highly overexpressed in prostate cancer. Cancer Res. 1999;59(23):5975–9.

    PubMed  CAS  Google Scholar 

  57. Marks LS, et al. PCA3 molecular urine assay for prostate cancer in men undergoing repeat biopsy. Urology. 2007;69(3):532–5.

    Article  PubMed  Google Scholar 

  58. Deras IL, et al. PCA3: a molecular urine assay for predicting prostate biopsy outcome. J Urol. 2008;179(4): 1587–92.

    Article  PubMed  Google Scholar 

  59. Aubin SM, et al. PCA3 molecular urine test for predicting repeat prostate biopsy outcome in populations at risk: validation in the placebo arm of the dutasteride REDUCE trial. J Urol. 2010;184(5):1947–52.

    Article  PubMed  Google Scholar 

  60. Nakanishi H, et al. PCA3 molecular urine assay correlates with prostate cancer tumor volume: implication in selecting candidates for active surveillance. J Urol. 2008;179(5):1804–9. discussion 1809–10.

    Article  PubMed  Google Scholar 

  61. de la Taille A, et al. Clinical evaluation of the PCA3 assay in guiding initial biopsy decisions. J Urol. 2011;185(6):2119–25.

    Article  PubMed  Google Scholar 

  62. Vickers AJ, et al. A panel of kallikrein markers can reduce unnecessary biopsy for prostate cancer: data from the European randomized study of prostate cancer screening in Goteborg, Sweden. BMC Med. 2008;6:19.

    Article  PubMed  Google Scholar 

  63. Benchikh A, et al. A panel of kallikrein markers can predict outcome of prostate biopsy following clinical work-up: an independent validation study from the European randomized study of prostate cancer screening, France. BMC Cancer. 2010;10:635.

    Article  PubMed  Google Scholar 

  64. Vickers A, et al. Reducing unnecessary biopsy during prostate cancer screening using a four-kallikrein panel: an independent replication. J Clin Oncol. 2010;28(15):2493–8.

    Article  PubMed  Google Scholar 

  65. Getzenberg RH, et al. Identification of nuclear matrix proteins in the cancer and normal rat prostate. Cancer Res. 1991;51(24):6514–20.

    PubMed  CAS  Google Scholar 

  66. Leman ES, et al. EPCA-2: a highly specific serum marker for prostate cancer. Urology. 2007;69(4): 714–20.

    Article  PubMed  Google Scholar 

  67. Herman JG, Baylin SB. Gene silencing in cancer in association with promoter hypermethylation. N Engl J Med. 2003;349(21):2042–54.

    Article  PubMed  CAS  Google Scholar 

  68. Nakayama M, et al. GSTP1 CpG island hypermethylation as a molecular biomarker for prostate cancer. J Cell Biochem. 2004;91(3):540–52.

    Article  PubMed  CAS  Google Scholar 

  69. Enokida H, et al. Multigene methylation analysis for detection and staging of prostate cancer. Clin Cancer Res. 2005;11(18):6582–8.

    Article  PubMed  CAS  Google Scholar 

  70. Kuzmin I, et al. The RASSF1A tumor suppressor gene is inactivated in prostate tumors and suppresses growth of prostate carcinoma cells. Cancer Res. 2002;62(12):3498–502.

    PubMed  CAS  Google Scholar 

  71. Woodson K, et al. CD44 and PTGS2 methylation are independent prognostic markers for biochemical recurrence among prostate cancer patients with clinically localized disease. Epigenetics. 2006;1(4): 183–6.

    Article  PubMed  Google Scholar 

  72. Nelson WG, De Marzo AM, Isaacs WB. Prostate cancer. N Engl J Med. 2003;349(4):366–81.

    Article  PubMed  CAS  Google Scholar 

  73. Roupret M, et al. Molecular detection of localized prostate cancer using quantitative methylation-specific PCR on urinary cells obtained following prostate massage. Clin Cancer Res. 2007;13(6):1720–5.

    Article  PubMed  CAS  Google Scholar 

  74. Perner S, et al. TMPRSS2:ERG fusion-associated deletions provide insight into the heterogeneity of prostate cancer. Cancer Res. 2006;66(17):8337–41.

    Article  PubMed  CAS  Google Scholar 

  75. 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. 2011;117(6):1210–9.

    Article  PubMed  Google Scholar 

  76. Gudmundsson J, et al. Genetic correction of PSA values using sequence variants associated with PSA levels. Sci Transl Med. 2010;2(62):62ra92.

    Article  PubMed  CAS  Google Scholar 

  77. American Urological Association Web site. 2011. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm. Accessed 15 Aug 2011.

  78. U.S. Preventive Services Task Force Web site. 2011. http://www.uspreventiveservicestaskforce.org/uspstf08/prostate/prostaters.htm. Accessed 15 Aug 2011.

  79. American Cancer Society Web site. 2011. http://www.cancer.org/Cancer/ProstateCancer/MoreInformation/ProstateCancerEarlyDetection/prostate-cancer-early-detection-acs-recommendations. Accessed 15 Aug 2011.

Download references

Author information

Authors and Affiliations

  1. Department of Urology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, 7845, San Antonio, TX, 78229, USA

    William M. Hilton M.D., Ian M. Thompson Jr. M.D. & Dipen J. Parekh

Authors
  1. William M. Hilton M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ian M. Thompson Jr. M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dipen J. Parekh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dipen J. Parekh .

Editor information

Editors and Affiliations

  1. Cleveland Clinic, Cleveland Clinic Lerner College of Medic, Department of Regional Urology, at Case Western Reserve, Cleveland, 44195, Ohio, USA

    J. Stephen Jones

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Hilton, W.M., Thompson, I.M., Parekh, D.J. (2013). Prostate Cancer Screening: Navigating the Controversy. In: Jones, J. (eds) Prostate Cancer Diagnosis. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-188-2_2

Download citation

  • DOI: https://doi.org/10.1007/978-1-62703-188-2_2

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-187-5

  • Online ISBN: 978-1-62703-188-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation