Clinical and pathological features of screen vs non-screen-detected prostate cancers: is there a difference?
Article first published online: 13 MAR 2008
© 2008 THE AUTHORS. JOURNAL COMPILATION © 2008 BJU INTERNATIONAL
Volume 102, Issue 1, pages 24–27, July 2008
How to Cite
Pelzer, A. E., Colleselli, D., Bektic, J., Schaefer, G., Ongarello, S., Schwentner, C., Pallwein, L., Mitterberger, M., Steiner, E., Bartsch, G. and Horninger, W. (2008), Clinical and pathological features of screen vs non-screen-detected prostate cancers: is there a difference?. BJU International, 102: 24–27. doi: 10.1111/j.1464-410X.2008.07566.x
- Issue published online: 13 MAR 2008
- Article first published online: 13 MAR 2008
- Accepted for publication 19 December 2007
To evaluate the clinical and pathological characteristics of screen vs non-screen-detected prostate cancers, to determine if there is a difference in the same prostate-specific antigen (PSA) range.
PATIENTS AND METHODS
In all, 997 patients who had had a radical prostatectomy were evaluated; 806 were Tyrolean screening volunteers, and 191 were from outside Tyrol, representing the ‘referred prostate cancer’ group. PSA level, age, prostate volume and pathological characteristics were assessed, as was the amount of over- and under-diagnosis.
There were no statistically significant differences in patient age or PSA levels in the two groups. Even in the same PSA range there were statistically significantly more extraprostatic cancers in the referral group, at 31.7% and 17.4%, respectively. In the referred and screening groups there was over-diagnosis in 7.9% and 16.8%, and under-diagnosis in 40.8% and 27.8%, respectively.
This study suggests that screening volunteers have a statistically significantly higher rate of organ-confined prostate cancers, and a statistically significantly lower rate of extracapsular extension and positive surgical margins than their counterparts in the referral group even in the same PSA range. As the pathological stage and surgical margin status are significant predictors of recurrence, these findings support the concept of PSA screening.