Screening for Prostate Cancer

  • Ian M. Thompson
  • John Foley
Part of the Current Clinical Urology book series (CCU)


Prostate cancer screening is a fait acomplis in the United States at this time. Regardless of whether it is justifiable from a scientific standpoint, it is occurring. The evidence for this statement can be found in the incidence rates of prostate cancer before and after the advent of prostate-specific antigen (PSA) screening. Figure 1 graphically demonstrates this phenomenon. PSA became widely available in 1987–1988, and screening for prostate cancer increased dramatically shortly thereafter.


Prostate Cancer Prostate Specific Antigen Radical Prostatectomy Natl Cancer Inst Localize Prostate Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    American Cancer Society web page: http://
  2. 2.
    American Academy of Family Physicians web page: .
  3. 3.
    Labrie F, Dupont A, Suburu R, et al. Serum prostate specific antigen as pre-screening test for prostate cancer. J Urol 1982; 147: 846.Google Scholar
  4. 4.
    Bangma CH, Rietbergen JB, Kranse R, Blijenberg BG, Petterson K, Schroder F. The free-to-total PSA ratio improves the specificity of prostate specific antigen in screening for prostate cancer in the general population. J Urol 1997; 57: 2191–2196.Google Scholar
  5. 5.
    Austin JP, Aziz H, Potters L, Thelmo W, Chen P, Choi K, et al. Diminished survival in young blacks with adenocarcinoma of the prostate. Am J Clin Oncol (CCT) 1990; 13: 465–469.CrossRefGoogle Scholar
  6. 6.
    Bratt O, Kristoffersson U, Lundgren R, Olsson H. The risk of malignant tumors in first-degree relatives of men with early onset prostate cancer: a population-based cohort study. EurJ Cancer 1997; 33: 2237–2240.CrossRefGoogle Scholar
  7. 7.
    Pienta KJ, Demers R, Hoff M, Kau TY, Montie JE, Severson RK. Efect of age and race on the survival of men with prostate cancer in the metropolitan Detroit tricounty area, 1973 to 1987. Urology 1995; 43: 93–102.Google Scholar
  8. 8.
    Yamamoto K, Hanada R, Tanimura M, Aihara T, Hayashi Y. Natural history of neuroblastoma found by mass screening [letter]. Lancet 1997; 349: 1102.PubMedCrossRefGoogle Scholar
  9. 9.
    Woods WG, Tuchman M, Robison LL, Bernstein M, Leclerc JM, Brisson LC, et al. A population-based study of the usefulness of screening for neuroblastoma. Lancet 1996; 348: 1682–1687.PubMedCrossRefGoogle Scholar
  10. 10.
    Whitmore WF Jr, Warner JA, Thompson IM. Expectant management of localized prostate cancer. Cancer 1991; 67: 1091–1096.PubMedCrossRefGoogle Scholar
  11. 11.
    Hanash KA, Utz DC, Cook EN, Taylor WF, Titus JL. Carcinoma of the prostate: a 15-year follow-up. J Urol 1972; 107: 450–453.PubMedGoogle Scholar
  12. 12.
    Johansson JE, Holmberg L, Johansson S, Bergstrom R, Adami HO. Fifteen-year survival in prostate cancer. A prospective, population-based study in Sweden. JAMA 1997; 277: 467–471.PubMedCrossRefGoogle Scholar
  13. 13.
    Fleming C, Wasson JH, Albertsen PC, Barry MJ, Wennberg JE. A decision analysis of alternative treatment strategies for clinically localized prostate cancer. Prostate Patient Outcomes Research Team. JAMA 1993; 269: 2650–2658.PubMedCrossRefGoogle Scholar
  14. 14.
    Cheng L, Neumann RM, Blute ML, Zincke H, Bostwick DG. Long-term follow-up of untreated state Tla prostate cancer [letter]. J Natl Cancer Inst 1998; 90: 1105–1107.PubMedCrossRefGoogle Scholar
  15. 15.
    Chodak GW, Thisted RA, Gerber GS, et al. Results of conservative management of clinically localized prostate cancer. N Engl J Med 1994; 330: 242–248.PubMedCrossRefGoogle Scholar
  16. 16.
    Weinstein MH, Greenspan DL, Epstein JL. Diagnoses rendered on prostate needle biopsy in community hospitals. Prostate 1998; 35: 50–55.PubMedCrossRefGoogle Scholar
  17. 17.
    Orozco R, O’Dowd G, Kunnel B, Miller MC, Veltri RW. Observations on pathology trends in 62,537 prostate biopsies obtained from urology private practices in the United States. Urology 1998; 51: 186–195.PubMedCrossRefGoogle Scholar
  18. 18.
    Albertsen PC, Murphy-Setzko MA, Hanley JA, Barry MJ, Gleason DF. Long-term survival following conservative management of localized prostate cancer: 15-year follow-up among men age 55–75. J Urol 1998; 159: 963A.Google Scholar
  19. 19.
    American Cancer Society. Cancer Facts and Figures-1998. American Cancer Society, Atlanta, GA.Google Scholar
  20. 20.
    Smith JR, Freije D, Carpten JD, Gronberg H, Xu J, Isaacs SD, et al. Major susceptibility locus for prostate cancer on Chromosome 1 suggeested by a genome-wide search. Science 1996; 274: 1371–1374.PubMedCrossRefGoogle Scholar
  21. 21.
    Thompson IM, Ernst JJ, Gangai MP, Spence CR. Adenocarcinoma of the prostate: results of routine urological screening. J Urol 1984; 132: 690.PubMedGoogle Scholar
  22. 22.
    Catalona WJ, Smith DS, Ratliff TL, Basler JW. Detection of organ-confined prostate cancer is increased through prostate-specific antigen-based screening. JAMA 1993; 270: 948–954.PubMedCrossRefGoogle Scholar
  23. 23.
    Devesa SS, Blot WJ, Stone BJ, Miller BA, Tarone RE, Faumeni JF. Recent cancer trends in the United States. J Natl Cancer Inst 1995; 87: 175–182.PubMedCrossRefGoogle Scholar
  24. 24.
    Brawley OW. Prostate carcinoma incidence and patient mortality. The effects of screening and early detection. Cancer 1997; 80: 1857–1863.Google Scholar
  25. 25.
    Smart CR. The results of prostate carcinoma screening the U.S. as reflected in the Surveillance, Epidemiology, and End Results Program. Cancer 1997; 80: 1835.PubMedCrossRefGoogle Scholar
  26. 26.
    Mettlin C, Murphy GP, Babaian RJ, Chesley A, Kane RA, Littrup PJ, et al. The results of a five-year early prostate cancer detection intervention. Cancer 1996; 77: 150–159.PubMedCrossRefGoogle Scholar
  27. 27.
    Svetec D, Thompson IM. PSA screening-current controversy. Ann Oncol 1998; 9: 1283–1288.PubMedCrossRefGoogle Scholar
  28. 28.
    Landis SH, Murray T, Bolder S, et al. Cancer statistics, 1998. CA 1998; 48: 6.Google Scholar
  29. 29.
    Roberts RO, Jacobsen SJ, Katusic SK, et al. Recent declines in prostate cancer incidence and mortality in Olmstead County, MN 1980–1995. J Urol 1998; 159: 474A.Google Scholar
  30. 30.
    Dugan JA, Bostwick DG, Myers RP, Qian J, Bergstralh EJ, Oesterling JE. The definition and preoperative prediction of clinically insignificant prostate cancer. JAMA 1996; 275: 288–294.PubMedCrossRefGoogle Scholar
  31. 31.
    Smith DS, Catalona WJ. The nature of prostate cancer detected through prostate specific antigen based screening. J Urol 1994; 152: 1732–1736.PubMedGoogle Scholar
  32. 32.
    Ohori M, Wheeler TM, Dunn JK, Stamey TA, Scardino PT. The pathological features and prognosis of prostate cancer detectable with current diagnostic tests. J Urol 1994; 152: 1714–1720.PubMedGoogle Scholar
  33. 33.
    Lodding P, Aus G, Bergdahl S, Frosing R, Lilja H, Pihl CG, Hugosson J. Characteristics of screening detected prostate cancer in men 50 to 66 years old with 3 to 4 ng/ml prostate specific antigen. J Urol 1998; 159: 899–903.PubMedCrossRefGoogle Scholar
  34. 34.
    Stricker HJ, Ruddock LI, Wan J, Belville WD. Detection of non-palpable prostate cancer. A mathematical and laboratory model. Br J Urol 1993; 71: 43–46.PubMedCrossRefGoogle Scholar
  35. 35.
    Belville WD. Prostate Cancer Screening. Presented during the 9th Annual South Texas Medical Surgical Society Meeting, Hay River, Canada, July 19, 1998.Google Scholar
  36. 36.
    Thompson IM, et al. Report on the Management of Clinically Localized Prostate Cancer. American Urological Association Clinical Guidelines Panel. Baltimore, MD, 1995.Google Scholar
  37. 37.
    Aus G, Hugosson J, Norlen L. Long-term survival and mortality in prostate cancer treated with non-curative intent. J Urol 1995; 154: 460–465.PubMedCrossRefGoogle Scholar
  38. 38.
    Jacobsen SJ, Bergstrahl EJ, Guess H, Katusic, SK, Klee GG, Oesterling J, et al. Predictive properties of prostate specific antigen testing in a community-based setting. Arch Inter Med 1996; 156: 2462–2468.CrossRefGoogle Scholar
  39. 39.
    Duffy SW, Chen HH, Tabar L, Fagerberg G, Paci E. Sojurn time, sensitivity, and positive predictive value of mammography screening for breast cancer in women aged 40–49. Int J Epidemiol 1996; 25: 1139–1145.PubMedCrossRefGoogle Scholar
  40. 40.
    Laya MB, Larson EB, Taplin SH, White E. Effect of estrogen replacement therapy on the specificity and sensitivity of screening mammography. J Natl Cancer Inst 1996; 88: 643–649.PubMedCrossRefGoogle Scholar
  41. 41.
    Pound CR, Partin AW, Epstein JI, Walsh PC. Prostate-specific antigen after anatomic radical retropubic prostatectomy. Urol Clin North Am 1997; 24: 395–406.PubMedCrossRefGoogle Scholar
  42. 42.
    Ohori M, Goad JR, Wheeler TM, Eastham JA, Thompson TC, Scardino PT. Can radical prostatectomy alter the progression of poorly differentiated prostate cancer? J Urol 1994; 152: 1843–1849.PubMedGoogle Scholar
  43. 43.
    Oefelein MG, Grayhack JT, McVary KT. Survival after radical retropubic prostatectomy of men with clinically localized high grade carcinoma of the prostate. Cancer 1995; 76: 2535–2542.PubMedCrossRefGoogle Scholar
  44. 44.
    Krongrad A, Lai H, Lai S. Survival after radical prostatectomy. JAMA 1997; 278: 44–46.PubMedCrossRefGoogle Scholar
  45. 45.
    Blasko JC, Ragde H, Luse RW, Sylvester JE, Cavanagh W, Grimm PD. Should brachytherapy be considered a therapeutic option in localized prostate cancer? Urol Clin North Am 1998; 23: 633–650.CrossRefGoogle Scholar
  46. 46.
    Thompson IM, Optenberg SA. An overview cost-utility analysis of prostate cancer screening. Oncology 1995; 9: 141–145.PubMedGoogle Scholar
  47. 47.
    Salzmann P, Kerlikowske K, Phillips K. Cost effectiveness of extending screening mammography guidelines to include women 40 to 49 years of age. Ann Inter Med 1997; 127: 955–965.Google Scholar
  48. 48.
    Labrie F, Dupont A, Candas B, Cusan L, Gomez JL, Diamond P, et al. Decrease of prostate cancer death by screening: First data from the Quebec prospective and randomized study. Proc ASCO 1998; 17: 2a.Google Scholar
  49. 49.
    Bairati I, Meyer F, Fradet Y, Moore L. Dietary fat and advanced prostate cancer. J Urol 1998; 159: 1271–1275.PubMedCrossRefGoogle Scholar
  50. 50.
    Trichopoulou A, Lagiou P. Correlating nutrition to recent cancer mortality statistics. J Natl Cancer Inst 1997; 89: 1725–1726.PubMedCrossRefGoogle Scholar
  51. 51.
    Goldstein NS, Begin LR, Grody WW, Novak JM, Qian J, Bostwick DG. Minimal or no cancer in radical prostatectomy specimens. Report of 13 cases of the “vanishing cancer phenomenon. ” Am J Surg Pathol 1995; 19: 1002–1009.PubMedCrossRefGoogle Scholar
  52. 52.
    DiGiuseppe JA, Sauvageot J, Epstein JL. Increasing incidence of minimal residual cancer in radical prostatectomy specimens. Am J Surg Pathol 1997; 21: 174–178.PubMedCrossRefGoogle Scholar
  53. 53.
    Adolfsson J, Austenfeld M, Thompson IM. The case for conservative therapy for localized prostate cancer. In: Raghavan D, Scher HI, Leibel SA, Lange PH, eds. Principles and Practice of Genitourinary Oncology. Lippincott-Raven, Philadelphia, 1997.Google Scholar
  54. 54.
    Oefelein MG, Smith N, Carter M, Dalton D, Schaeffer A. The incidence of prostate cancer progression with undetectable serum prostate specific antigen in a series of 394 radical prostatectomies. J Urol 1995; 154: 2128–2131.PubMedCrossRefGoogle Scholar
  55. 55.
    Paulson DF, Moul J`.’, Walther PJ. Radical prostatectomy for clinical stage T 1–2NOMO prostatic adenocarcinoma: Long-term results. J Urol 1990; 144: 1180–1184.PubMedGoogle Scholar
  56. 56.
    Ohori M, Wheeler TM, Kattan MW, Goto Y, Scardino PT. Prognostic significant of positive surgical margins in radical prostatectomy specimens. J Urol 1995; 154: 1818–1824.PubMedCrossRefGoogle Scholar
  57. 57.
    Litwin MS, Pasta DJ, Stoddard ML, Henning JM, Carroll PR. Epidemiological trends and financial outcomes in radical prostatectomy among Medicare beneficiaries,1991 to 1993. J Urol 1998; 160: 445–448.PubMedCrossRefGoogle Scholar
  58. 58.
    Middleton RG, Thompson IM, Austenfeld MS, et al. Prostate cancer clinical guidelines panel summary report on the management of clinically localized prostate cancer. J Urol 1995; 154: 2144–2148.PubMedCrossRefGoogle Scholar
  59. 59.
    Geary ES, Dendinger TE, Freiha FS, Stamey TA. Nerve sparing radical prostatectomy: a different view. J Urol 1995; 154: 145–149.PubMedCrossRefGoogle Scholar
  60. 60.
    Es sink-Bot ML, Koning HJd, Nijs HGT, Kirkels SWJ, van der Maas PJ, Schroder FH. Short-term effects of population-based screening for prostate cancer on health-related quality of life. J Natl Cancer Inst 1998; 90: 925–931.Google Scholar
  61. 61.
    Crowley J. Interpreting Clinical Trials 2: Factorial Designs, Subset Analyses, and Intent to Treat. American Society of Clinical Oncology Instructional Handbook, 1998 Annual Meeting.Google Scholar
  62. 62.
    Harlan L, Brawley O, Pommerenke F, Wali P, Kramer B. Geographic, Age, and racial variation in the treatment of local/regional carcinoma of the prostate. J Clin Oncol 1995; 13: 93–100.PubMedGoogle Scholar
  63. 63.
    Lubke WL, Optenberg SA, Thompson IM. Analysis of the first-year cost of a prostate cancer screening and treatment program in the United States. J Natl Cancer Inst 1994; 86: 1790.PubMedCrossRefGoogle Scholar
  64. 64.
    Gohagan JK, Prorok PC, Kramer BS, Cornett JE. Prostate cancer screening in the prostate, lung, colorectal, ovarian cancer screening trial of the National Cancer Institute. J Urol 1994; 152: 1905–1909.PubMedGoogle Scholar

Copyright information

© Humana Press Inc., Totowa, NJ 2000

Authors and Affiliations

  • Ian M. Thompson
  • John Foley

There are no affiliations available

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