The High Prevalence of Undiagnosed Prostate Cancer at Autopsy: Implications for Epidemiology and Treatment of Prostate Cancer in the Prostate-Specific Antigen-Era
Jaquelyn L. Jahn,Jaquelyn L. Jahn,Edward Giovannucci,Edward Giovannucci,Meir J. Stampfer,Meir J. Stampfer +5 more
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TLDR
The prevalence of unsuspected prostate cancer discovered at autopsy among 6,024 men was reviewed, and among men aged 70–79, tumor was found in 36% of Caucasians and 51% of African‐Americans.Abstract:
Widespread prostate-specific antigen (PSA) screening detects many cancers that would have otherwise gone undiagnosed. To estimate the prevalence of unsuspected prostate cancer, we reviewed 19 studies of prostate cancer discovered at autopsy among 6,024 men. Among men aged 70-79, tumor was found in 36% of Caucasians and 51% of African-Americans. This enormous prevalence, coupled with the high sensitivity of PSA screening, has led to the marked increase in the apparent incidence of prostate cancer. The impact of PSA screening on clinical practice is well-recognized, but its effect on epidemiologic research is less appreciated. Before screening, a larger proportion of incident prostate cancers had lethal potential and were diagnosed at advanced stage. However, in the PSA era, overall incident prostate cancer mainly is indolent disease, and often reflects the propensity to be screened and biopsied. Studies must therefore focus on cancers with lethal potential, and include long follow-up to accommodate the lead time induced by screening. Moreover, risk factor patterns differ markedly for potentially lethal and indolent disease, suggesting separate etiologies and distinct disease entities. Studies of total incident or indolent prostate cancer are of limited clinical utility, and the main focus of research should be on prostate cancers of lethal potential.read more
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Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement.
David C Grossman,Susan J. Curry,Douglas K Owens,Douglas K Owens,Kirsten Bibbins-Domingo,Aaron B. Caughey,Karina W. Davidson,Chyke A. Doubeni,Mark H. Ebell,John W. Epling,Alex R. Kemper,Alex H. Krist,Martha Y. Kubik,C. Seth Landefeld,Carol M. Mangione,Michael Silverstein,Melissa A. Simon,Albert L. Siu,Albert L. Siu,Chien-Wen Tseng +19 more
TL;DR: The USPSTF concludes with moderate certainty that the net benefit of PSA-based screening for prostate cancer in men aged 55 to 69 years is small for some men.
Journal ArticleDOI
The Epidemiology of Prostate Cancer.
TL;DR: The state of evidence for specific genetic, lifestyle, and dietary factors associated with prostate cancer risk is discussed, including genetics, obesity and weight change, physical activity, smoking, lycopene and tomatoes, fish, vitamin D and calcium, and statins.
Journal ArticleDOI
Exosome-based liquid biopsies in cancer: opportunities and challenges.
W. Yu,James Hurley,D. Roberts,Sudipto K. Chakrabortty,D. Enderle,Mikkel Noerholm,Xandra O. Breakefield,Johan Skog +7 more
TL;DR: In this article, the authors discuss the advantages and challenges of exosome-based liquid biopsies for tumor biomarkers and clinical implementation in the context of circulating tumor DNA and circulating tumor cells.
Journal ArticleDOI
Molecular Imaging of Prostate Cancer.
Andreas Wibmer,Irene A. Burger,Evis Sala,Hedvig Hricak,Wolfgang A. Weber,Hebert Alberto Vargas +5 more
TL;DR: Because metastatic prostate cancer cells induce osteoblastic signaling pathways of adjacent bone tissue, bone-seeking radiotracers are sensitive tools for the detection of metastases to bone.
Journal ArticleDOI
Baseline Prostate-Specific Antigen Levels in Midlife Predict Lethal Prostate Cancer
Mark A. Preston,Julie L. Batista,Kathryn M. Wilson,Sigrid V. Carlsson,Travis Gerke,Daniel Sjöberg,Douglas M. Dahl,Howard D. Sesso,Adam S. Feldman,Peter H. Gann,Adam S. Kibel,Andrew J. Vickers,Lorelei A. Mucci +12 more
TL;DR: PSA levels in midlife strongly predict future lethal PCa in a US cohort subject to opportunistic screening and risk-stratified screening on the basis of midlife PSA should be considered in men age 45 to 59 years.
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Journal ArticleDOI
Screening for Prostate Cancer: U.S. Preventive Services Task Force Recommendation Statement
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Journal ArticleDOI
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Journal ArticleDOI
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TL;DR: In this update the ERSPC confirms a substantial reduction in prostate cancer mortality attributable to testing of PSA, with a substantially increased absolute effect at 13 years compared with findings after 9 and 11 years.
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