This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mäkinen, T. Articles by Auvinen, A. Search for Related Content PubMed PubMed Citation Articles by Mäkinen, T. Articles by Auvinen, A.

Tumor Characteristics in a Population-based Prostate Cancer Screening Trial with Prostate-specific Antigen¹

Department of Surgery, Seinäjoki Central Hospital, FIN-60220 Seinäjoki [T. M.]; Department of Urology, Tampere University Hospital and Medical School [T. L. J. T.] and Tampere School of Public Health [M. H., A. A.], University of Tampere, Tampere; Departments of Clinical Chemistry [U-H. S.] and Urology [S. R., J. A.], Helsinki University Central Hospital, Helsinki; Department of Surgery, Jorvi Hospital, Helsinki University Central Hospital, Espoo [H. J.]; and Finnish Cancer Registry, Helsinki [L. M.], Finland

Purpose: Early diagnosis of prostate cancer is a necessary, but not sufficient, prerequisite for an effective screening program aiming at mortality reduction. We compared tumor characteristics between the screening and control arms in the Finnish population-based screening trial.

Experimental Design: The Finnish trial is the largest component in the European Randomized Study of Screening for Prostate Cancer. A total of 24,000 men aged 55–67 years were randomized to the screening arm, whereas 35,973 men formed the control arm during the first three screening years. At the time of invitation, 22,732 men were eligible for screening, and 15,685 (69%) participated. A prostate-specific antigen (PSA) concentration of 4 µg/liter was defined as a screening-positive finding.

Results: The detection rate among screenees was 2.4% (377 of 15,685), whereas 0.6% (40 of 7,047) of nonparticipants in the screening arm and 0.3% (112 of 35,973) of the controls were diagnosed with prostate cancer during the first postrandomization year in the absence of screening. In the screening arm, 82% of the cancers were clinically organ confined compared with 65% in the control arm. Yet, both the absolute number and cumulative incidence of advanced cancer were higher in the screening arm. No differences were seen in the WHO grade distribution between the study groups. The median PSA was substantially lower among screen-detected cases (7.1 µg/liter) than among nonattenders (15.7 µg/liter) and controls (13.2 µg/liter).

Conclusions: Our findings on intermediate indicators of PSA screening provide encouraging, yet inconclusive evidence for eventual mortality reduction.

This article has been cited by other articles:

				C. M. Sturgeon, M. J. Duffy, U.-H. Stenman, H. Lilja, N. Brunner, D. W. Chan, R. Babaian, R. C. Bast Jr., B. Dowell, F. J. Esteva, et al. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Testicular, Prostate, Colorectal, Breast, and Ovarian Cancers Clin. Chem., December 1, 2008; 54(12): e11 - e79. [Abstract] [Full Text] [PDF]

				Y.-C. Chuan, S.-T. Pang, A. Cedazo-Minguez, G. Norstedt, A. Pousette, and A. Flores-Morales Androgen Induction of Prostate Cancer Cell Invasion Is Mediated by Ezrin J. Biol. Chem., October 6, 2006; 281(40): 29938 - 29948. [Abstract] [Full Text] [PDF]