Incidental Prostatic Adenocarcinomas and Putative Premalignant Lesions in TURP Specimens Collected Before and After the Introduction of Prostrate-Specific Antigen Screening

2000 ◽  
Vol 124 (10) ◽  
pp. 1454-1456
Author(s):  
Kien T. Mai ◽  
Phillip A. Isotalo ◽  
Jerome Green ◽  
D. Garth Perkins ◽  
Christopher Morash ◽  
...  
Keyword(s):  
Specific Antigen ◽  
Intraepithelial Neoplasia ◽  
Premalignant Lesions ◽  
Transurethral Resection Of Prostate ◽  
Psa Screening ◽  
Before And After ◽  
Clinical Detection ◽  
Time Periods ◽  
Prostrate Specific Antigen ◽  
Comparison Of The Results

Abstract Background.—Since the introduction of prostate-specific antigen (PSA) screening for the detection of prostatic adenocarcinoma (PCA), there has been an increase in the incidence of stage T1c PCA. The purpose of this study was to compare the frequency of incidental PCA found in transurethral resection of prostate (TURP) specimens for a 14-month period during 1989–1990 (before PSA screening was available) with the incidence of PCA for a 32-month period during 1997–1999 (after PSA screening became available). Design.—Consecutive TURP specimens from the 2 time periods were reviewed to identify incidental PCA, prostatic intraepithelial neoplasia (PIN), and atypical adenomatous hyperplasia (AAH). Cases of TURP for palliative treatment of known advanced PCA were excluded from the study. All TURP specimens were fixed in 10% buffered formalin and were processed according to the same protocol. Results.—We reviewed 533 and 449 TURP specimens for the time periods 1989–1990 and 1997–1999, respectively. Comparison of the results for these 2 time periods revealed that the combined prevalence of T1a and T1b PCA decreased over time from 12.9% to 8.0% (P = .06) with the introduction of PSA screening. A new group of T1c PCA was established in the post-PSA screening period of 1997–1999. There were no statistically significant differences in the incidences of T1a PCA, PIN, and AAH in TURP specimens for the 2 time periods. Conclusion.—The decreased incidence of T1b PCA in TURP specimens for the 1997–1999 period represents a shift in PCA staging. Some PCAs previously staged as T1b are now staged as T2 carcinomas, as a result of PSA screening and earlier clinical detection. The introduction of PSA screening has had no influence on the incidence of T1a PCA, PIN, or AAH in TURP specimens.

scholarly journals Histomorphological spectrum of prostatic lesions: a retrospective analysis of transurethral resection of prostate specimens

2017 ◽  
Vol 5 (6) ◽  
pp. 2373 ◽  
Author(s):  
Anuja Sharma ◽  
Mahima Sharma ◽  
Shivani Gandhi ◽  
Arvind Khajuria ◽  
K. C. Goswami
Keyword(s):  
Prostate Cancer ◽  
Transurethral Resection ◽  
Intraepithelial Neoplasia ◽  
Premalignant Lesions ◽  
Transurethral Resection Of Prostate ◽  
Incidental Prostate Cancer ◽  
Mortality And Morbidity ◽  
Graduate Department ◽  
Causes Of Mortality ◽  
Prostatic Diseases

Background: Prostatic diseases like inflammation, benign prostatic hyperplasia and tumors are important causes of mortality and morbidity in males. The incidence of these lesions increases with advancing age. The second most common cancer among males is prostate cancer, next to lung cancer worldwide. Transurethral resection of prostate (TURP) is most frequently preformed surgical procedure in the clinical practice. The purpose of the study is to evaluate histomorphological spectrum of prostate lesions in TURP specimen with focus on premalignant lesions and incidental carcinomas.Methods: The present study includes 245 cases of TURP specimen from January 2015 to December 2016 received in the post graduate department of pathology, ASCOMS and Hospital. H and E stained sections were examined. The relevant clinical details pertaining to age, clinical complaints and microscopic details were analysed and compared with other similar studies.Results: Of the total 245 TURP specimen, 223 (91.02%) were of nodular hyperplasia, 14 (5.71%) were of prostatic intraepithelial neoplasia and 8 (3.26%) cases were malignant. Benign hyperplasia of prostate (BHP) alone accounted for 91.02% of TURP specimen. Less frequent findings were granulomatous prostatitis in 3.70% and atypical adenomatous hyperplasia (1.22%). All the 8 cases of prostate cancer were incidental carcinoma, 5 of which were poorly differentiated and 3 were moderately differentiated adenocarcinoma.Conclusions: The present study showed that non-neoplastic lesions of prostate are more common than neoplastic ones. The most frequently encountered prostatic lesion was BHP, commonly seen in the age group of 61-70 years. The malignant lesions were common among the males of more than 60 years. TURP can be helpful in early identification of premalignant lesions and incidental prostate cancer which can improve the treatment outcome of patients.

Review of Free Prostate-Specific Antigen Assay Utilization at Danbury Hospital

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S148-S149
Author(s):  
Quoc Nguyen ◽  
Salvador Sena
Keyword(s):  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Diagnostic Errors ◽  
Free Fraction ◽  
Gray Zone ◽  
Time Period ◽  
Before And After ◽  
Negative Findings ◽  
Time Periods ◽  
Total Psa

Abstract Introduction Measuring the concentration of free fraction of prostate-specific antigen (fPSA) present in serum in addition to the total PSA (tPSA) concentration has been shown to enhance specificity over tPSA alone in evaluating male patients with mild-moderate elevations of tPSA in the diagnostic “gray zone” (4.0-10.0 ng/mL) and negative findings on digital rectal exam. The clinical utility of fPSA has not been demonstrated outside the tPSA gray zone, as the probability of prostate cancer is very low at tPSA <4.0 and very high at tPSA >10.0. However, many clinicians order tPSA and fPSA concurrently without first knowing the results of the tPSA. This study was to review orders for fPSA and provide suggestions for improving utilization. Methods Paired test results for concurrently ordered tPSA and fPSA tests during the time periods of January to February 2018 and January to February 2019 (before and after laboratory information system upgrade) were extracted for quality assurance purposes. No patient identifiers were included. Data were sorted and the percentage of “appropriate” fPSA orders was calculated for each time period. Results The number of concurrent total and fPSA tests ordered was 174 for January-February 2018 and 232 for January-February 2019. The number of tPSA within the 4.0 to 10.0 ng/mL range was 78 for January-February 2018 and 148 for January-February 2019. The percentage of “appropriate” fPSA test orders (tPSA 4.0-10.0 ng/mL) was 44.8% for January-February 2018 and 63.8% for January-February 2019. Conclusion A high percentage of inappropriate fPSA orders was found during both time periods. Inappropriate fPSA testing is not only unnecessary and wasteful but can lead to diagnostic errors. Options for driving improved utilization include automatic canceling of fPSA orders when tPSA is not within the diagnostic gray zone and offering fPSA as a “reflex” test that is performed only when tPSA is within the diagnostic gray zone.

scholarly journals The Association of Veterans’ PSA Screening Rates With Changes in USPSTF Recommendations

2020 ◽  
Author(s):  
Daniel J Becker ◽  
Temitope Rude ◽  
Dawn Walter ◽  
Chan Wang ◽  
Stacy Loeb ◽  
...  
Keyword(s):  
Task Force ◽  
Statistical Tests ◽  
Specific Antigen ◽  
The United States ◽  
Veterans Health ◽  
Health Administration ◽  
Psa Screening ◽  
Psa Testing ◽  
Before And After ◽  
Preventative Services

Abstract Background In 2012, the United States Preventative Services Task Force (USPSTF) formally recommended against all prostate-specific antigen (PSA) screening for prostate cancer. Our goal was to characterize PSA screening trends in the Veterans Health Administration (VA) before and after the USPSTF recommendation and to determine if PSA screening was more likely to be ordered based on a veteran’s race or age. Methods Using the VA Corporate Data Warehouse, we created 10 annual groups of PSA-eligible men covering 2009-2018. We identified all PSA tests performed in the VA to determine yearly rates of PSA screening. All statistical tests were 2-sided. Results The overall rate of PSA testing in the VA decreased from 63.3% in 2009 to 51.2% in 2018 (P &lt; .001). PSA screening rates varied markedly by age group during our study period, with men aged 70-80 years having the highest initial rate and greatest decline (70.6% in 2009 to 48.4% in 2018, P &lt; .001). Men aged 55-69 years had a smaller decline (65.2% in 2009 to 58.9% in 2018, P &lt; .001) whereas the youngest men, aged 40-54 years, had an increase in PSA screening (26.2% in 2009 to 37.8% in 2018, P &lt; .001). Conclusions In this analysis of PSA screening rates among veterans before and after the 2012 USPSTF recommendation against screening, we found that overall PSA screening decreased only modestly, continuing for more than one-half of the men in our study. Veterans of different races had similar screening rates, suggesting that VA care may minimize racial disparities. Veterans of varying ages experienced statistically significantly differences in PSA screening trends.

scholarly journals Global Trends of Latent Prostate Cancer in Autopsy Studies

Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 359
Author(s):  
Takahiro Kimura ◽  
Shun Sato ◽  
Hiroyuki Takahashi ◽  
Shin Egawa
Keyword(s):  
Prostate Cancer ◽  
Racial Differences ◽  
Specific Antigen ◽  
Tumor Location ◽  
Cancer Registration ◽  
Asian Countries ◽  
Global Trends ◽  
Psa Screening ◽  
Asian Men ◽  
Definition Of

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.

Prostate-specific antigen testing in the disabled population: A cross-sectional analysis of the Health Information National Trends Survey (HINTS).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17000-e17000
Author(s):  
Joon Yau Leong ◽  
Ruben Pinkhasov ◽  
Thenappan Chandrasekar ◽  
Oleg Shapiro ◽  
Michael Daneshvar ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Information ◽  
Prostate Specific Antigen ◽  
Healthcare Provider ◽  
Specific Antigen ◽  
Cross Sectional ◽  
Psa Screening ◽  
Psa Testing ◽  
The Usa ◽  
National Trends

e17000 Background: Disabled patients are a unique minority population that may have lower literacy levels and difficulty communicating with physicians. Furthermore, their knowledge for cancer prevention recommendations is unknown. Herein, we aim to compare prostate-specific antigen (PSA) testing rates and associated predictors among disabled men and non-disabled men in the USA. Methods: We performed a cross-sectional study utilizing the Health Information National Trends Survey (HINTS) to analyze factors predicting PSA testing rates in men with disabilities (disabled, deaf, blind). Multivariable logistic regression models were used to determine clinically significant predictors of PSA testing in men with disabilities compared to that of the healthy cohort. Results: A total of 782 (14.6%) disabled men were compared to 4,569 (85.4%) non-disabled men. Disabled men were older with a mean age of 65.0 ± 14.2 vs. 55.0 ± 15.9 years (p < 0.001). On multivariable analysis, after adjusting for all available confounders including race, age, geographical region, survey year, marital status, health insurance, healthcare provider, amongst others, men with any disability were less likely to undergo PSA screening (OR 0.772, 95% CI 0.623-0.956, p = 0.018). Variables associated with increased PSA screening rates included age, having a healthcare provider or health insurance, and living with a partner. Although prostate cancer detection rates were shown to be higher among disabled men, this did not reach statistical significance. Conclusions: Our data suggests that significant inequalities in PSA screening exist among men with disabilities in the USA, with disabled men, especially the deaf and the blind, being less likely to be offered PSA screening. There is a clear need to implement strategies to reduce existing gaps in the care of disabled men and strive to reach equality in PSA screening in this unique population.

Human mobility models reveal the underlying mechanism of seasonal movements across China

2021 ◽  
Author(s):  
Bing Song ◽  
Xiao-Yong Yan ◽  
Suoyi Tan ◽  
Bin Sai ◽  
Shengjie Lai ◽  
...  
Keyword(s):  
Traffic Engineering ◽  
Human Mobility ◽  
Underlying Mechanism ◽  
Gravity Models ◽  
Mobility Models ◽  
Temporal And Spatial Distribution ◽  
Population Movements ◽  
Different Types ◽  
Before And After ◽  
Time Periods

Understanding the spatial interactions of human mobility is crucial for urban planning, traffic engineering, as well as for the prevention and control of infectious diseases. Although many models have been developed to model human mobility, it is not clear whether such models could also capture the traveling mechanisms across different time periods (e.g. workdays, weekends or holidays). With one-year long nationwide location-based service (LBS) data in China, we investigate the spatiotemporal characteristics of population movements during different time periods, and make thorough comparisons for the applicability of five state-of-the-art human mobility models. We find that population flows show significant periodicity and strong inequality across temporal and spatial distribution. A strong “backflow” effect is found for cross-city movements before and after holidays. Parameter fitting of gravity models reveals that travels in different type of days consider the attractiveness of destinations and cost of distance differently. Surprisingly, the comparison indicates that the parameter-free opportunity priority selection (OPS) model outperforms other models and is the best to characterize human mobility in China across all six different types of days. However, there is still an urgent need for development of more dedicated models for human mobility on weekends and different types of holidays.

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