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Cumulative probability of prostate cancer detection in biopsy according to free/total PSA ratio in men with total PSA levels of 2.1–10.0 ng/ml at population screening

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Abstract

Purpose

The aim of this study was to investigate the cumulative probability of prostate cancer detection according to free/total prostate-specific antigen (PSA) ratio in men with PSA levels of 2.1–10.0 ng/ml and also likelihood of detecting clinically insignificant prostate cancer in population-based screening.

Methods

A total of 1,277 men aged between 55 and 69 years with total PSA (tPSA) levels of 2.1–10.0 ng/ml screened in population screening in Kanazawa city and underwent systematic transrectal ultrasonography-guided prostate biopsy between 2000 and 2011 were enrolled. The cumulative probability of prostate cancer detection in biopsy according to age, serum tPSA, and free-to-total PSA (f/t PSA) ratio was investigated. The clinicopathological features of screening-detected prostate cancer were also investigated.

Results

Of the 1,277 subjects in the study population, 320 (25.0 %) were diagnosed with prostate cancer during the observation period. The probabilities of prostate cancer detection at 3 years were 64.5, 41.2, 28.5, and 14.3 % for the men with f/t PSA ratio ≤0.08, 0.09–0.13, 0.14–0.22, and ≥0.23, respectively; the differences in probabilities of prostate cancer detection among men with different f/t PSA ratios were statistically significant. Among 320 patients, 84 (26.3 %) had favorable clinicopathological features that made them suitable for active surveillance. The f/t PSA ratio in unfavorable cancer patients was significantly lower that that in favorable cancer patients.

Conclusion

The present study demonstrated that the f/t PSA ratio was a strong predictor of future cancer detection and unfavorable cancerous features in prostate biopsy in men with total PSA levels of 2.1–10.0 ng/ml at population screening.

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Acknowledgments

We thank Dr. Mitsuharu Sasaki of Tohoku University, Sendai, Japan, for valuable advice. We also thank Dr. Yasuo Takeda and Dr. Atsushi Hashiba of Kanazawa Medical Association for providing data of the Kanazawa population-based screening cohort.

Conflict of interest

None declared.

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Authors and Affiliations

  1. Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University, Takaramachi 13-1, Kanazawa, Ishikawa, 920-8640, Japan

    Yasuhide Kitagawa, Satoru Ueno, Kouji Izumi, Yoshifumi Kadono, Hiroyuki Konaka, Atsushi Mizokami & Mikio Namiki

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  1. Yasuhide Kitagawa
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  2. Satoru Ueno
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  3. Kouji Izumi
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  4. Yoshifumi Kadono
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  5. Hiroyuki Konaka
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  6. Atsushi Mizokami
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  7. Mikio Namiki
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Correspondence to Yasuhide Kitagawa.

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Kitagawa, Y., Ueno, S., Izumi, K. et al. Cumulative probability of prostate cancer detection in biopsy according to free/total PSA ratio in men with total PSA levels of 2.1–10.0 ng/ml at population screening. J Cancer Res Clin Oncol 140, 53–59 (2014). https://doi.org/10.1007/s00432-013-1543-9

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  • DOI: https://doi.org/10.1007/s00432-013-1543-9

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