An Estimate of Prostate Cancer Prevalence in Italy

Estimates of the total number of men with a previous diagnosis of prostate cancer in Italy range from 55,000 to 135,000. This wide range of variation is largely due to uncertainties on the number of protein-specific antigen-detected, asymptomatic cases. The number of clinically detected cases, including cases with advanced disease, is less subject to uncertainty, with reasonable estimates ranging from 45,000 to 60,000.

Download Full-text

Prostate Cancer

10.1093/oso/9780190676827.003.0020 ◽

2018 ◽

Author(s):

Kathryn M. Wilson ◽

Lorelei Mucci

Keyword(s):

Prostate Cancer ◽

Risk Factors ◽

Family History ◽

Prostate Specific Antigen ◽

Advanced Prostate Cancer ◽

Advanced Disease ◽

African Ancestry ◽

Specific Antigen ◽

Dietary Factors ◽

Increased Risk

Prostate cancer is among the most commonly diagnosed cancers among men, ranking second in cancer globally and first in Western countries. There are marked variations in incidence globally, and its incidence must be interpreted in the context of diagnostic intensity and screening. The uptake of prostate-specific antigen screening since the 1990s has led to dramatic increases in incidence in many countries, resulting in an increased proportion of indolent cancers that would never have come to light clinically in the absence of screening. Risk factors differ when studying prostate cancer overall versus advanced disease. Older age, African ancestry, and family history are established risk factors for prostate cancer. Obesity and smoking are not associated with risk overall, but are associated with increased risk of advanced prostate cancer. Several additional lifestyle factors, medications, and dietary factors are now emerging as risk factors for advanced disease.

Download Full-text

ECONOMIC EVALUATION OF DIAGNOSTIC LOCALIZATION FOLLOWING BIOCHEMICAL PROSTATE CANCER RECURRENCE

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462314000476 ◽

2014 ◽

Vol 30 (4) ◽

pp. 345-353 ◽

Cited By ~ 2

Author(s):

Daniel A. Barocas ◽

Mark E. Bensink ◽

Kristin Berry ◽

Zahra Musa ◽

Carolyn Bodnar ◽

...

Keyword(s):

Prostate Cancer ◽

Cost Effectiveness ◽

Radical Prostatectomy ◽

Metastatic Disease ◽

Specific Antigen ◽

Base Case ◽

Diagnostic Strategy ◽

Potential Cost ◽

Life Years ◽

Wide Range

Objectives: The aim of this study was to assess potential cost-effectiveness of using a prostate cancer specific functional imaging technology capable of identifying residual localized disease versus small volume metastatic disease for asymptomatic men with low but detectable prostate specific antigen (PSA) elevation following radical prostatectomy.Methods: Markov modeling was used to estimate the incremental impact on healthcare system costs (2012 USD) and quality-adjusted life-years (QALYs) of two alternative strategies: (i) using the new diagnostic to guide therapy versus (ii) current usual care—using a combination of computed tomography, magnetic resonance imaging, and bone scan to guide therapy. Costs were based on estimates from literature and Medicare reimbursement. Prostate cancer progression, survival, utilities, and background risk of all-cause mortality were obtained from literature. Base-case diagnostic sensitivity (75 percent), specificity (90 percent), and cost (USD 2,500) were provided by our industry partner GE Healthcare.Results: The new diagnostic strategy provided an average gain of 1.83 (95 percent uncertainty interval [UI]: 1.24–2.64) QALYs with added costs of USD 15,595 (95 percent UI: USD -6,330–44,402) over 35 years. The resulting incremental cost-effectiveness ratio was USD 8,516/QALY (95 percent UI: USD -2,947–22,372). Results were most influenced by the utility discounting rate and test performance characteristics; however, the new diagnostic provided clinical benefits over a wide range of sensitivity and specificity.Conclusion: This analysis suggests a diagnostic technology capable of identifying whether men with biochemical recurrence after radical prostatectomy have localized versus metastatic disease would be a cost-effective alternative to current standard work-up. The results support additional investment in development and validation of such a diagnostic.

Download Full-text

Glycans as Biomarkers in Prostate Cancer

International Journal of Molecular Sciences ◽

10.3390/ijms20061389 ◽

2019 ◽

Vol 20 (6) ◽

pp. 1389 ◽

Cited By ~ 18

Author(s):

Emma Scott ◽

Jennifer Munkley

Keyword(s):

Prostate Cancer ◽

Specific Antigen ◽

Liquid Biopsies ◽

Multifaceted Approach ◽

Disease Biomarkers ◽

High Profile ◽

Psa Testing ◽

Wide Range ◽

Multifocal Disease ◽

Core Fucosylation

Prostate cancer is the most commonly diagnosed malignancy in men, claiming over350,000 lives worldwide annually. Current diagnosis relies on prostate-specific antigen (PSA)testing, but this misses some aggressive tumours, and leads to the overtreatment of non-harmfuldisease. Hence, there is an urgent unmet clinical need to identify new diagnostic and prognosticbiomarkers. As prostate cancer is a heterogeneous and multifocal disease, it is likely that multiplebiomarkers will be needed to guide clinical decisions. Fluid-based biomarkers would be ideal, andattention is now turning to minimally invasive liquid biopsies, which enable the analysis oftumour components in patient blood or urine. Effective diagnostics using liquid biopsies willrequire a multifaceted approach, and a recent high-profile review discussed combining multipleanalytes, including changes to the tumour transcriptome, epigenome, proteome, and metabolome.However, the concentration on genomics-based paramaters for analysing liquid biopsies ispotentially missing a goldmine. Glycans have shown huge promise as disease biomarkers, anddata suggests that integrating biomarkers across multi-omic platforms (including changes to theglycome) can improve the stratification of patients with prostate cancer. A wide range ofalterations to glycans have been observed in prostate cancer, including changes to PSAglycosylation, increased sialylation and core fucosylation, increased O-GlcNacylation, theemergence of cryptic and branched N-glyans, and changes to galectins and proteoglycans. In thisreview, we discuss the huge potential to exploit glycans as diagnostic and prognostic biomarkersfor prostate cancer, and argue that the inclusion of glycans in a multi-analyte liquid biopsy test forprostate cancer will help maximise clinical utility.

Download Full-text

Utility and limits of serum prostate specific antigen determinations in prostatic cancer staging in view of surgical treatment

Urologia Journal ◽

10.1177/039156039205900417 ◽

1992 ◽

Vol 59 (4) ◽

pp. 65-67 ◽

Cited By ~ 1

Author(s):

S. Rocca Rossetti ◽

D.F. Randone ◽

C. Terrone ◽

M. Pasquale ◽

F. Pecchio

Keyword(s):

Prostate Cancer ◽

Prostate Specific Antigen ◽

Specific Antigen ◽

Cancer Staging ◽

Pathological Stage ◽

Clinical Value ◽

Predictive Values ◽

Serum Prostate Specific Antigen ◽

Wide Range ◽

Retropubic Radical Prostatectomy

We investigated the clinical value of serum prostate specific antigen in 35 patients with apparently localized prostate cancer who underwent retropubic radical prostatectomy at our Department. In this series preoperative prostate specific antigen levels tended to increase with the increasing severity of pathological stage. The positive and negative predictive values were 68.1% and 63.6% respectively, accuracy was 66.6%. In the case of lymph node involvment, PSA values were lower than 10 nanog./ml in 20% of cases. Prostate specific antigen values not useful to predict preoperatively the final pathological stage of the prostate cancer because of the wide range of values among patients within each stage.

Download Full-text

Glycosylation: Rising Potential for Prostate Cancer Evaluation

Cancers ◽

10.3390/cancers13153726 ◽

2021 ◽

Vol 13 (15) ◽

pp. 3726

Author(s):

Anna Kałuża ◽

Justyna Szczykutowicz ◽

Mirosława Ferens-Sieczkowska

Keyword(s):

Prostate Cancer ◽

Cancer Detection ◽

Protein Function ◽

Cell Signalling ◽

Specific Antigen ◽

Protein Glycosylation ◽

Biological Processes ◽

Wide Range ◽

Core Fucosylation ◽

Modify Protein

Prostate cancer is the second most commonly diagnosed cancer among men. Alterations in protein glycosylation are confirmed to be a reliable hallmark of cancer. Prostate-specific antigen is the biomarker that is used most frequently for prostate cancer detection, although its lack of sensitivity and specificity results in many unnecessary biopsies. A wide range of glycosylation alterations in prostate cancer cells, including increased sialylation and fucosylation, can modify protein function and play a crucial role in many important biological processes in cancer, including cell signalling, adhesion, migration, and cellular metabolism. In this review, we summarize studies evaluating the prostate cancer associated glycosylation related alterations in sialylation, mainly α2,3-sialylation, core fucosylation, branched N-glycans, LacdiNAc group and presence of truncated O-glycans (sTn, sT antigen). Finally, we discuss the great potential to make use of glycans as diagnostic and prognostic biomarkers for prostate cancer.

Download Full-text

Effect of bicalutamide 150 mg on PSA progression in M0 prostate cancer: Results from the Early Prostate Cancer program

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.4624 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 4624-4624 ◽

Cited By ~ 1

Author(s):

W. A. See ◽

D. G. McLeod ◽

P. Iversen ◽

M. P. Wirth ◽

J. Armstrong ◽

...

Keyword(s):

Prostate Cancer ◽

Standard Care ◽

Advanced Disease ◽

Locally Advanced ◽

Specific Antigen ◽

Disease Stage ◽

Primary Therapy ◽

Locally Advanced Disease ◽

Early Prostate Cancer ◽

Psa Progression

4624 Background: Prostate-specific antigen (PSA) progression is the first sign of prostate cancer recurrence after primary therapy. In the Early Prostate Cancer (EPC) program, men with locally advanced disease who received bicalutamide 150 mg (CASODEX) in addition to standard care (radiotherapy [RT], radical prostatectomy [RP], or watchful waiting [WW]) had significantly improved objective progression-free survival (PFS) vs standard care alone. In the RT setting, this translated into improved overall survival (OS). Here, we compare PSA-PFS in the 3rd analysis of the EPC program with the results for objective PFS. Methods: The EPC program consists of 3 trials in which patients (all M0) with either localized (T1–2, N0/Nx) or locally advanced (T3–4, any N; or any T, N+) prostate cancer were randomized to receive standard care plus either bicalutamide 150 mg (n = 4052) or placebo (n = 4061). The primary end points were OS and objective PFS. PSA-PFS was a secondary end point. A PSA progression event was defined as PSA rising to ≥2× baseline or ≥0.4 ng/mL in men with non-quantifiable baseline PSA, death, or objective progression. PSA-PFS and objective PFS were analyzed for stage/therapy subgroups using a Cox proportional hazards model. Results: At 7.4 years’ median follow-up, bicalutamide plus standard care was associated with significantly improved PSA-PFS vs placebo (p < 0.001), irrespective of primary therapy or disease stage. However, PSA-PFS benefit only translated into a significant objective PFS benefit in locally advanced disease ( table ). Conclusion: Adding bicalutamide 150 mg to standard care significantly improves PSA-PFS for men with early, non-metastatic prostate cancer. The significant improvement in PSA-PFS was only accompanied by a significant improvement in objective PFS in locally advanced disease. Consequently, a significant PSA-PFS benefit cannot always be assumed to translate into a significant objective PFS benefit. [Table: see text] [Table: see text]

Download Full-text

Multisite experience of fluciclovine (18F) PET/CT imaging in biochemically recurrent prostate cancer: Impact of clinical factors and intersite variation.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.6_suppl.163 ◽

2017 ◽

Vol 35 (6_suppl) ◽

pp. 163-163

Author(s):

Lucia Zanoni ◽

Christina Nanni ◽

Tore Bach-Gansmo ◽

Trond V Bogsrud ◽

Peter Nieh ◽

...

Keyword(s):

Prostate Cancer ◽

Specific Antigen ◽

Ct Scanning ◽

Clinical Factors ◽

Detection Rates ◽

Prostate Bed ◽

Pet Ct ◽

Wide Range ◽

The Impact ◽

Baseline Psa

163 Background: Fluciclovine (18F) is an FDA-approved positron emission tomography/computerized tomography (PET/CT) tracer in clinical use for the detection and localization of biochemically recurrent (BCR) prostate cancer. Here, we report the impact of clinical factors and study site on its performance. Methods: In total, 596 subjects with BCR prostate cancer underwent fluciclovine (18F) PET/CT scanning at four sites in Italy, Norway and USA. Detection Rates (DR), including region level analyses, were stratified by prostate specific antigen (PSA) levels, PSA doubling time (PSAdt), Gleason score (GS), and by investigator/site. Extra-prostatic disease was defined as all positivity outside of residual prostate, prostate bed and seminal vesicles. Results: Fluciclovine (18F) PET/CT was positive in 67.7% (403/595) of subjects. Positive findings were detected in the prostate/bed and pelvic lymph node regions in 38.7% (232/599) and 32.6% (194/596) of scans, respectively. Metastatic involvement outside the pelvis was found in 26.2% (155/591) of scans. Generally, DR increased with increasing baseline PSA (Table 1). While subject level DR did not vary significantly with PSAdt (DR = 60-69% across all categories), a positive extra-prostatic scan was more likely in patients with shorter PSAdt (DR = 52%, 48%, 37% and 28% for PSAdt <3, 3-<6, 6-<12 and >12 months, respectively). Among 361 subjects for whom baseline GS was available, scores ≥9 were associated with the highest extra-prostatic DR (55%) compared with 23% in patients with GS ≤6. Inter-site variations in acquisition protocols may have impacted DR at low baseline PSA values; with subject level DR at PSA >0.2-0.5 ng/ml = 20%, 38%, 46% and 73% at site A, B, C and D, respectively. Conclusions: Fluciclovine (18F) can detect and localize BCR prostate cancer in a wide range of subjects and, with appropriate imaging protocols, has a clinically useful DR at PSA <0.5 ng/ml. Clinical trial information: NCT02443571. [Table: see text]

Download Full-text

The Distribution of Serum Prostate-Specific Antigen Levels Among American Men: Implications for Prostate Cancer Prevalence and Screening

The Prostate ◽

10.1002/pros.20417 ◽

2006 ◽

Vol 66 (10) ◽

pp. 1044-1051 ◽

Cited By ~ 20

Author(s):

Michael P. Porter ◽

Janet L. Stanford ◽

Paul H. Lange

Keyword(s):

Prostate Cancer ◽

Prostate Specific Antigen ◽

Specific Antigen ◽

Cancer Prevalence ◽

Serum Prostate Specific Antigen

Download Full-text

Prostate Cancer Specific Exosomal miRNAs in Saliva: a Way to a New and Dependable Screening Method

10.21203/rs.3.rs-122436/v1 ◽

2020 ◽

Author(s):

Christoph Lüdemann ◽

Jan-Ludwig Reinersmann ◽

Claudia Klinger ◽

Stephan Degener ◽

Nici Marcus Dreger ◽

...

Keyword(s):

Prostate Cancer ◽

Screening Method ◽

Specific Antigen ◽

Test Method ◽

The Other ◽

Diagnostic Tools ◽

Control Group ◽

Cancer Type ◽

Significant Group ◽

Wide Range

Abstract Background: Today, prostate cancer (PCa) is by far the most common cancer type among men. Diagnostic tests for PCa usually involve blood level testing of prostate-specific antigen (PSA) and transrectal, ultrasound-guided biopsy of the prostatic gland. Both diagnostic tools are unsatisfying in terms of low specificity and poor sensitivity. A general characterization of prostate cancer is difficult since the course of the disease varies individually from latent slow growing to aggressive and rapidly lethal tumors. However, no matter the severity of the disease, a possibility to increase the prognostic chances is the early detection. Regular cancer screening can be an appropriate concept if the tools are right. So far, PSA reaches its limits when it comes to an accurate distinction between cancerous glands and benign processes. miRNAs offer hope to overcome these drawbacks by virtue of their cancer-specific expression. Circulating miRNAs are an active area of current investigation and hold promise to serve a wide range of clinical applications and unwrap a new era in cancer diagnosis and therapeutics. miRNAs have proven their diagnostic potential of becoming a biomolecule of clinical relevance in a variety of human body fluid like blood/serum, urine, and saliva.Methods: We measured expression levels of 16 circulating prostate cancer specific miRNAs in saliva exosomes via qRT-PCR and compared differences between men suffering from prostate cancer and men suffering from other diseases of the urogenital tract, which formed the no-cancer control group. Differentiation strength of significant sequences was determined via ROC curve analysis. Results: hsa-mir-331 and hsa-mir-200b were significantly reduced in patients suffering from prostate cancer compared to the no-caner control group. Diagnostic quality of determined cut off values showed moderate differentiation strength with dependable diagnostic properties. The other 14 examined prostate cancer specific microRNAs showed no significant group differences. Conclusions: hsa-mir-331 and hsa-mir-200b are promising biomarkers for a reliable non-invasive and saliva-based test method in prostate cancer diagnostics. In a synopsis of the results in other studies and against the background of the chastening results of the other miRNAs analyzed, this is exciting news.

Download Full-text