Individualizing PSA Monitoring Among Older Prostate Cancer Survivors
Prostate cancer survivors are the largest group of male cancer survivors (41%) and most are over age 65.1 Following curative-intent surgery or radiation, some data suggest interventions given shortly after early detection of biochemical recurrence (i.e., isolated prostate-specific antigen [PSA] elevation) may improve prostate cancer-specific survival.2 However, PSA monitoring may lead to complications from invasive diagnostics or treatment, and may be unnecessary in older men with a history of low-risk cancer or limited life expectancy due to the long lead time (5–8 years) between PSA biochemical recurrence and metastatic disease.2,3Therefore, we examined national VA and Medicare data of older men treated for localized prostate cancer with radiation or radical prostatectomy to determine if PSA monitoring is more frequent among older men with substantial life expectancy and/or history of high-risk cancer, who are most likely to benefit, and less frequent among older men...
KEY WORDSaging survivorship PSA monitoring prostate cancer
This work was supported by the National Institute on Aging at the National Institutes of Health (grant number K24AG041180) to [LW].
The funding sources had no role in the design, conduct, or analysis of this study or in the decision to submit the manuscript for publication.
Compliance with Ethical Standards
The Committee on Human Research at the University of California, San Francisco, and the Committee for Research and Development at the San Francisco VA Medical Center approved this study. The corresponding author, Louise Walter, had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The datasets generated during and/or analyzed during the current study are not publicly available because Veterans Affairs data are not publicly available. However, all datasets used in this study are available to VA investigators through VIReC, http://vaww.virec.research.va.gov/Index-VACMS.htm
Conflict of Interest
The authors declare that they do not have a conflict of interest.