Significance of PSA Screening in Niigata, Japan: Survey of Actual Status of New Cases of Prostate Cancer

The incidence of prostate cancer (PC) has been increasing in Asian countries, where it was previously low. Although the adoption of a Westernized lifestyle is a possible explanation, the incidence is statistically biased due to the increase in prostate-specific antigen (PSA) screening and the accuracy of national cancer registration systems. Studies on latent PC provide less biased information. This review included studies evaluating latent PC in several countries after excluding studies using random or single-section evaluations and those that did not mention section thickness. The findings showed that latent PC prevalence has been stable since 1950 in Western countries, but has increased over time in Asian countries. Latent PC in Asian men has increased in both prevalence and number of high-grade cases. Racial differences between Caucasian and Asian men may explain the tumor location of latent PC. In conclusion, the recent increase in latent PC in Asian men is consistent with an increase in clinical PC. Evidence suggests that this increase is caused not only by the increase in PSA screening, but also by the adoption of a more Westernized lifestyle. Autopsy findings suggest the need to reconsider the definition of clinically insignificant PC.

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Re: Dudith Pierre-Victor, Howard L. Parnes, Gerald L. Andriole, et al. Prostate Cancer Incidence and Mortality Following a Negative Biopsy in a Population Undergoing PSA Screening. Urology 2021 Jun 26;S0090-4295(21)00539-2.

Urology ◽

10.1016/j.urology.2021.07.020 ◽

2021 ◽

Author(s):

Patrick Lewicki ◽

Camilo Arenas-Gallo ◽

Spyridon P. Basourakos ◽

Bashir Al Hussein Al Awamlh ◽

Siv Venkat ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Incidence ◽

Prostate Cancer Incidence ◽

Negative Biopsy ◽

Psa Screening ◽

Incidence And Mortality

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The Long Term Twenty Year Impact of PSA Screening in the United States: Decrease in the Diagnosis of Stage IV Prostate Cancer (PC) Compared to Additional Treatment of Low/intermediate Risk PC

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2014.05.635 ◽

2014 ◽

Vol 90 (1) ◽

pp. S154

Author(s):

X. Shen ◽

P. Kumar

Keyword(s):

Prostate Cancer ◽

United States ◽

Stage Iv ◽

The United States ◽

Additional Treatment ◽

Intermediate Risk ◽

Psa Screening

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EVALUATION OF PREVENTIVE TECHNOLOGIES IN GERMANY

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462301106057 ◽

2001 ◽

Vol 17 (3) ◽

pp. 329-337 ◽

Cited By ~ 4

Author(s):

Matthias Perleth ◽

Reinhard Busse ◽

Bernhard Gibis ◽

Angela Brand

Keyword(s):

Prostate Cancer ◽

Mammography Screening ◽

Preventive Measures ◽

Screening Program ◽

Normal Pregnancy ◽

Sufficient Evidence ◽

German Studies ◽

Psa Screening ◽

German Healthcare System ◽

Mammography Screening Program

Objective: In this article, three preventive strategies—mammography screening for breast cancer, PSA screening for prostate cancer, and routine ultrasound in normal pregnancy—are discussed in the context of German health care.Methods: Epidemiologic data and German studies evaluating different aspects of these preventive measures were identified and analyzed.Results: Only a few studies could be identified that investigate these preventive measures. Despite sufficient evidence, in part derived from a German study, there is not yet a mammography screening program. In contrast, ultrasound in pregnancy is offered routinely, although there are controversies regarding the benefit of this practice. PSA screening is not offered as part of the screening program for prostate cancer. However, PSA tests as well as mammographies are done in large numbers in German ambulatory care—a practice that could be considered wild or opportunistic screening.Conclusions: These case studies show that preventive programs and practices in Germany are not sufficiently based on sound evidence. The paucity of evaluation activities related to prevention in Germany is probably due to the low threshold to introduce new preventive programs into the German healthcare system in the past.

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Risk-adapted approach to prostate cancer screening

Cancer Urology ◽

10.17650/1726-9776-2018-14-2-109-121 ◽

2018 ◽

Vol 14 (2) ◽

pp. 109-121 ◽

Cited By ~ 1

Author(s):

A. A. Kirichek ◽

L. N. Lyubchenko ◽

V. B. Matveev

Keyword(s):

Prostate Cancer ◽

Early Detection ◽

Germline Mutation ◽

Prostate Cancer Screening ◽

Germline Mutations ◽

Polygenic Inheritance ◽

Psa Screening ◽

Psa Testing ◽

Mutation Carriers ◽

Brca1 Brca2

Mass prostatic specific antigen (PSA) testing (population-based PSA screening) has remained controversial, nevertheless there are men cohorts likely to benefit from PSA screening. Heritable factors contribute to 60 % risk for developing familial prostate cancer. Despite the fact that its clinical application is challenging due to polygenic inheritance, advances in new generation sequencing technologies permit identifying highly penetrant germline mutations in genes BRCA1, BRCA2, CHEK2, HOXB13 and MMR associated with tremendous increase in risk of developing the prostate cancer. Several germline mutations are associated with clinically aggressiveness of disease and shortened survival. Targeted screening that is based on family history and genomic aberrations should be the next step towards the precision medicine. Men at elevated risk should been performed for early detection are those with familiar history of prostate cancer, or BRCA1, BRCA2, CHEK2, HOXB13 and MMR pathogenic germline mutation carriers, or first line relatives diagnosed with certain types of cancer. Systematic PSA testing in 1–2 years among germline mutation carriers men beginning at age 45 years would contribute to increase in early detection of localized prostate cancer resulting in more chance of curative treatment and improve survival rates

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