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BJU Int. 2016 Dec;118(6):911-918. doi: 10.1111/bju.13422. Epub 2016 Feb 29.

Prostate-specific antigen patterns in US and European populations: comparison of six diverse cohorts.

Author information

1
School of Social and Community Medicine, University of Bristol, Bristol, UK.
2
NIHR Bristol Nutrition Biomedical Research Unit, University of Bristol, Bristol, UK.
3
Division of Urology, University of Connecticut Health Center, Farmington, CT, USA.
4
Institution of Surgical Sciences, Department of Urology, Uppsala University, Uppsala, Sweden.
5
Department of Urology, Johns Hopkins School of Medicine, Baltimore, MA, USA.
6
Department of Urology, University Medical Centre Utrecht, Utrecht, The Netherlands.
7
National Institute on Aging, National Institutes of Health, Baltimore, MA, USA.
8
Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
9
Faculty of Life Sciences and Medicine, King's College London, London, UK.
10
Regional Cancer Centre, Uppsala/Örebro Region, Uppsala, Sweden.
11
Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
12
Department of Oncology, University of Cambridge, Cambridge, UK.
13
Academic Urology Unit, Royal Marsden Hospital, Institute of Cancer Research, London, UK.

Abstract

OBJECTIVE:

To determine whether there are differences in prostate-specific antigen (PSA) levels at diagnosis or changes in PSA levels between US and European populations of men with and without prostate cancer (PCa).

SUBJECTS AND METHODS:

We analysed repeated measures of PSA from six clinically and geographically diverse cohorts of men: two cohorts with PSA-detected PCa, two cohorts with clinically detected PCa and two cohorts without PCa. Using multilevel models, average PSA at diagnosis and PSA change over time were compared among study populations.

RESULTS:

The annual percentage PSA change of 4-5% was similar between men without cancer and men with PSA-detected cancer. PSA at diagnosis was 1.7 ng/mL lower in a US cohort of men with PSA-detected PCa (95% confidence interval 1.3-2.0 ng/mL), compared with a UK cohort of men with PSA-detected PCa, but there was no evidence of a different rate of PSA change between these populations.

CONCLUSION:

We found that PSA changes over time are similar in UK and US men diagnosed through PSA testing and even in men without PCa. Further development of PSA models to monitor men on active surveillance should be undertaken in order to take advantage of these similarities. We found no evidence that guidelines for using PSA to monitor men cannot be passed between US and European studies.

KEYWORDS:

active surveillance; prostate cancer; prostate specific antigen

PMID:
26799945
DOI:
10.1111/bju.13422
[Indexed for MEDLINE]
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