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Optimal screening interval for men with low baseline prostate-specific antigen levels (≤1.0 ng/mL) in a prostate cancer screening program

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Abstract

Purpose

To optimize the rescreening schedule for men with low baseline prostate-specific antigen (PSA) levels, we evaluated men with baseline PSA levels of ≤1.0 ng/mL in PSA-based population screening.

Methods

We enrolled 8086 men aged 55–69 years with baseline PSA levels of ≤1.0 ng/mL, who were screened annually. The relationships of baseline PSA and age with the cumulative risks and clinicopathological features of screening-detected cancer were investigated.

Results

Among the 8086 participants, 28 (0.35 %) and 18 (0.22 %) were diagnosed with prostate cancer and cancer with a Gleason score (GS) of ≥7 during the observation period, respectively. The cumulative probabilities of prostate cancer at 12 years were 0.42, 1.0, 3.4, and 4.3 % in men with baseline PSA levels of 0.0–0.4, 0.5–0.6, 0.7–0.8, and 0.9–1.0 ng/mL, respectively. Those with GS of ≥7 had cumulative probabilities of 0.42, 0.73, 2.8, and 1.9 %, respectively. The cumulative probabilities of prostate cancer were significantly lower when baseline PSA levels were 0.0–0.6 ng/mL compared with 0.7–1.0 ng/mL. Prostate cancer with a GS of ≥7 was not detected during the first 10 years of screening when baseline PSA levels were 0.0–0.6 ng/mL and was not detected during the first 2 years when baseline PSA levels were 0.7–1.0 ng/mL.

Conclusions

Our study demonstrated that men with baseline PSA levels of 0.0–0.6 ng/mL might benefit from longer screening intervals than those recommended in the guidelines of the Japanese Urological Association. Further investigation is needed to confirm the optimal screening interval for men with low baseline PSA levels.

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Acknowledgments

We thank Dr. Kazuto Ito of Gunma University, Maebashi for valuable advice.

Authors’ contributions

S Urata was involved in data analysis and manuscript writing. Y Kitagawa was involved in protocol/project development, data management, and manuscript editing. S Matsuyama, R Naito, and K Yasuda collected the data. A Mizokami was involved in data collection and data management. M Namiki was involved in protocol/project development.

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Authors and Affiliations

  1. Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University, Takaramachi 13-1, Kanazawa, Ishikawa, 920-8640, Japan

    Satoko Urata, Yasuhide Kitagawa, Satoko Matsuyama, Renato Naito, Atsushi Mizokami & Mikio Namiki

  2. Kanazawa Medical Association, Kanazawa, Ishikawa, Japan

    Kenji Yasuda

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  1. Satoko Urata
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  2. Yasuhide Kitagawa
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  4. Renato Naito
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  5. Kenji Yasuda
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  6. Atsushi Mizokami
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  7. Mikio Namiki
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Corresponding author

Correspondence to Yasuhide Kitagawa.

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The authors have no conflicts of interest.

Ethical standards

This study has been approved by an institutional review board for research in Kanazawa University (1558-1 Kanazawa University Hospital). There is no patient identifying information included in this manuscript.

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Urata, S., Kitagawa, Y., Matsuyama, S. et al. Optimal screening interval for men with low baseline prostate-specific antigen levels (≤1.0 ng/mL) in a prostate cancer screening program. World J Urol 35, 579–586 (2017). https://doi.org/10.1007/s00345-016-1894-3

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  • DOI: https://doi.org/10.1007/s00345-016-1894-3

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