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Metastatic prostate cancer incidence and prostate-specific antigen testing: New insights from the European Randomized Study of Screening for Prostate Cancer

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Metastatic prostate cancer incidence and prostate-specific antigen testing : New insights from the European Randomized Study of Screening for Prostate Cancer. / Buzzoni, Carlotta; Auvinen, Anssi; Roobol, Monique J.; Carlsson, Sigrid; Moss, Sue M.; Puliti, Donella; De Koning, Harry J.; Bangma, Chris H.; Denis, Louis J.; Kwiatkowski, Maciej; Lujan, Marcos; Nelen, Vera; Paez, Alvaro; Randazzo, Marco; Rebillard, Xavier; Tammela, Teuvo L.J.; Villers, Arnauld; Hugosson, Jonas; Schröder, Fritz H.; Zappa, Marco.

In: European Urology, Vol. 68, No. 5, 01.11.2015, p. 885-890.

Research output: Contribution to journalArticleScientificpeer-review

Harvard

Buzzoni, C, Auvinen, A, Roobol, MJ, Carlsson, S, Moss, SM, Puliti, D, De Koning, HJ, Bangma, CH, Denis, LJ, Kwiatkowski, M, Lujan, M, Nelen, V, Paez, A, Randazzo, M, Rebillard, X, Tammela, TLJ, Villers, A, Hugosson, J, Schröder, FH & Zappa, M 2015, 'Metastatic prostate cancer incidence and prostate-specific antigen testing: New insights from the European Randomized Study of Screening for Prostate Cancer', European Urology, vol. 68, no. 5, pp. 885-890. https://doi.org/10.1016/j.eururo.2015.02.042

APA

Buzzoni, C., Auvinen, A., Roobol, M. J., Carlsson, S., Moss, S. M., Puliti, D., ... Zappa, M. (2015). Metastatic prostate cancer incidence and prostate-specific antigen testing: New insights from the European Randomized Study of Screening for Prostate Cancer. European Urology, 68(5), 885-890. https://doi.org/10.1016/j.eururo.2015.02.042

Vancouver

Author

Buzzoni, Carlotta ; Auvinen, Anssi ; Roobol, Monique J. ; Carlsson, Sigrid ; Moss, Sue M. ; Puliti, Donella ; De Koning, Harry J. ; Bangma, Chris H. ; Denis, Louis J. ; Kwiatkowski, Maciej ; Lujan, Marcos ; Nelen, Vera ; Paez, Alvaro ; Randazzo, Marco ; Rebillard, Xavier ; Tammela, Teuvo L.J. ; Villers, Arnauld ; Hugosson, Jonas ; Schröder, Fritz H. ; Zappa, Marco. / Metastatic prostate cancer incidence and prostate-specific antigen testing : New insights from the European Randomized Study of Screening for Prostate Cancer. In: European Urology. 2015 ; Vol. 68, No. 5. pp. 885-890.

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@article{c2e47c4687bf42fa8c1ddf453162403f,
title = "Metastatic prostate cancer incidence and prostate-specific antigen testing: New insights from the European Randomized Study of Screening for Prostate Cancer",
abstract = "Background The European Randomized Study of Screening for Prostate Cancer (ERSPC) has shown a 21{\%} reduction in prostate cancer (PCa) mortality and a 1.6-fold increase in PCa incidence with prostate-specific antigen (PSA)-based screening (at 13 yr of follow-up). We evaluated PCa incidence by risk category at diagnosis across the study arms to assess the potential impact on PCa mortality. Design, setting, and participants Information on arm, centre, T and M stage, Gleason score, serum PSA at diagnosis, age at randomisation, follow-up time, and vital status were extracted from the ERSPC database. Four risk categories at diagnosis were defined: 1, low; 2, intermediate; 3, high; 4, metastatic disease. PSA (≤100 or >100 ng/ml) was used as the indicator of metastasis. Outcome measurements and statistical analysis Incidence rate ratios (IRRs) for screening versus control arm by risk category at diagnosis and follow-up time were calculated using Poisson regression analysis for seven centres. Follow-up was truncated at 13 yr. Missing data were imputed using chained equations. The analyses were carried out on an intention-to-treat basis. Results and limitations In the screening arm, 7408 PCa cases were diagnosed and 6107 in the control arm. The proportion of missing stage, Gleason score, or PSA value was comparable in the two arms (8{\%} vs 10{\%}), but differed among centres. The IRRs were elevated in the screening arm for the low-risk (IRR: 2.14; 95{\%} CI, 2.03-2.25) and intermediate-risk (IRR: 1.24; 95{\%} CI, 1.16-1.34) categories at diagnosis, equal to unity for the high-risk category at diagnosis (IRR: 1.00; 95{\%} CI, 0.89-1.13), and reduced for metastatic disease at diagnosis (IRR: 0.60; 95{\%} CI, 0.52-0.70). The IRR of metastatic disease had temporal pattern similar to mortality, shifted forwards an average of almost 3 yr, although the mortality reduction was smaller. Conclusions The results confirm a reduction in metastatic disease at diagnosis in the screening arm, preceding mortality reduction by almost 3 yr. Patient summary The findings of this study indicate that the decrease in metastatic disease at diagnosis is the major determinant of the prostate cancer mortality reduction in the European Randomized study of Screening for Prostate Cancer.",
keywords = "Metastatic cancer incidence, Mortality reduction, Prostate screening, PSA",
author = "Carlotta Buzzoni and Anssi Auvinen and Roobol, {Monique J.} and Sigrid Carlsson and Moss, {Sue M.} and Donella Puliti and {De Koning}, {Harry J.} and Bangma, {Chris H.} and Denis, {Louis J.} and Maciej Kwiatkowski and Marcos Lujan and Vera Nelen and Alvaro Paez and Marco Randazzo and Xavier Rebillard and Tammela, {Teuvo L.J.} and Arnauld Villers and Jonas Hugosson and Schr{\"o}der, {Fritz H.} and Marco Zappa",
year = "2015",
month = "11",
day = "1",
doi = "10.1016/j.eururo.2015.02.042",
language = "English",
volume = "68",
pages = "885--890",
journal = "European Urology",
issn = "0302-2838",
publisher = "Elsevier",
number = "5",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Metastatic prostate cancer incidence and prostate-specific antigen testing

T2 - New insights from the European Randomized Study of Screening for Prostate Cancer

AU - Buzzoni, Carlotta

AU - Auvinen, Anssi

AU - Roobol, Monique J.

AU - Carlsson, Sigrid

AU - Moss, Sue M.

AU - Puliti, Donella

AU - De Koning, Harry J.

AU - Bangma, Chris H.

AU - Denis, Louis J.

AU - Kwiatkowski, Maciej

AU - Lujan, Marcos

AU - Nelen, Vera

AU - Paez, Alvaro

AU - Randazzo, Marco

AU - Rebillard, Xavier

AU - Tammela, Teuvo L.J.

AU - Villers, Arnauld

AU - Hugosson, Jonas

AU - Schröder, Fritz H.

AU - Zappa, Marco

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Background The European Randomized Study of Screening for Prostate Cancer (ERSPC) has shown a 21% reduction in prostate cancer (PCa) mortality and a 1.6-fold increase in PCa incidence with prostate-specific antigen (PSA)-based screening (at 13 yr of follow-up). We evaluated PCa incidence by risk category at diagnosis across the study arms to assess the potential impact on PCa mortality. Design, setting, and participants Information on arm, centre, T and M stage, Gleason score, serum PSA at diagnosis, age at randomisation, follow-up time, and vital status were extracted from the ERSPC database. Four risk categories at diagnosis were defined: 1, low; 2, intermediate; 3, high; 4, metastatic disease. PSA (≤100 or >100 ng/ml) was used as the indicator of metastasis. Outcome measurements and statistical analysis Incidence rate ratios (IRRs) for screening versus control arm by risk category at diagnosis and follow-up time were calculated using Poisson regression analysis for seven centres. Follow-up was truncated at 13 yr. Missing data were imputed using chained equations. The analyses were carried out on an intention-to-treat basis. Results and limitations In the screening arm, 7408 PCa cases were diagnosed and 6107 in the control arm. The proportion of missing stage, Gleason score, or PSA value was comparable in the two arms (8% vs 10%), but differed among centres. The IRRs were elevated in the screening arm for the low-risk (IRR: 2.14; 95% CI, 2.03-2.25) and intermediate-risk (IRR: 1.24; 95% CI, 1.16-1.34) categories at diagnosis, equal to unity for the high-risk category at diagnosis (IRR: 1.00; 95% CI, 0.89-1.13), and reduced for metastatic disease at diagnosis (IRR: 0.60; 95% CI, 0.52-0.70). The IRR of metastatic disease had temporal pattern similar to mortality, shifted forwards an average of almost 3 yr, although the mortality reduction was smaller. Conclusions The results confirm a reduction in metastatic disease at diagnosis in the screening arm, preceding mortality reduction by almost 3 yr. Patient summary The findings of this study indicate that the decrease in metastatic disease at diagnosis is the major determinant of the prostate cancer mortality reduction in the European Randomized study of Screening for Prostate Cancer.

AB - Background The European Randomized Study of Screening for Prostate Cancer (ERSPC) has shown a 21% reduction in prostate cancer (PCa) mortality and a 1.6-fold increase in PCa incidence with prostate-specific antigen (PSA)-based screening (at 13 yr of follow-up). We evaluated PCa incidence by risk category at diagnosis across the study arms to assess the potential impact on PCa mortality. Design, setting, and participants Information on arm, centre, T and M stage, Gleason score, serum PSA at diagnosis, age at randomisation, follow-up time, and vital status were extracted from the ERSPC database. Four risk categories at diagnosis were defined: 1, low; 2, intermediate; 3, high; 4, metastatic disease. PSA (≤100 or >100 ng/ml) was used as the indicator of metastasis. Outcome measurements and statistical analysis Incidence rate ratios (IRRs) for screening versus control arm by risk category at diagnosis and follow-up time were calculated using Poisson regression analysis for seven centres. Follow-up was truncated at 13 yr. Missing data were imputed using chained equations. The analyses were carried out on an intention-to-treat basis. Results and limitations In the screening arm, 7408 PCa cases were diagnosed and 6107 in the control arm. The proportion of missing stage, Gleason score, or PSA value was comparable in the two arms (8% vs 10%), but differed among centres. The IRRs were elevated in the screening arm for the low-risk (IRR: 2.14; 95% CI, 2.03-2.25) and intermediate-risk (IRR: 1.24; 95% CI, 1.16-1.34) categories at diagnosis, equal to unity for the high-risk category at diagnosis (IRR: 1.00; 95% CI, 0.89-1.13), and reduced for metastatic disease at diagnosis (IRR: 0.60; 95% CI, 0.52-0.70). The IRR of metastatic disease had temporal pattern similar to mortality, shifted forwards an average of almost 3 yr, although the mortality reduction was smaller. Conclusions The results confirm a reduction in metastatic disease at diagnosis in the screening arm, preceding mortality reduction by almost 3 yr. Patient summary The findings of this study indicate that the decrease in metastatic disease at diagnosis is the major determinant of the prostate cancer mortality reduction in the European Randomized study of Screening for Prostate Cancer.

KW - Metastatic cancer incidence

KW - Mortality reduction

KW - Prostate screening

KW - PSA

UR - http://www.scopus.com/inward/record.url?scp=84942983796&partnerID=8YFLogxK

U2 - 10.1016/j.eururo.2015.02.042

DO - 10.1016/j.eururo.2015.02.042

M3 - Article

VL - 68

SP - 885

EP - 890

JO - European Urology

JF - European Urology

SN - 0302-2838

IS - 5

ER -