Prostate-specific antigen testing of older men

H. Ballentine Carter, Patricia K. Landis, E. Metter, Lee A. Fleisher, Jay D. Pearson

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: Elevated serum prostate-specific antigen (PSA) levels are predictive of a future diagnosis of prostate cancer. To test the hypothesis that older men with low PSA levels may require less intensive PSA testing because of a reduced prostate cancer detection rate, we evaluated the association between age, baseline PSA level, and prostate cancer detection. Methods: We conducted a prospective cohort study among participants in a study of aging who had serial PSA measurements taken from age 60 or 65 years until they either were diagnosed with prostate cancer (cancer case subjects) or reached the age of 75 years (subjects without prostate cancer). The time of cancer detection among cancer case subjects was defined as the measurement date on which a PSA level above 4.0 ng/mL was detected (i.e., PSA conversion). Cancer case subjects and subjects without prostate cancer were analyzed according to baseline PSA level and age. Results: All cancer case subjects in the 60-year-old cohort had baseline PSA levels above 0.5 ng/mL, and 14 of 15 cancer cases that would have been detected by a PSA conversion among the 65-year-old cohort were associated with baseline PSA levels of 1.1 ng/mL or more. If PSA testing were discontinued in men aged 65 years with PSA levels of 0.5 ng/mL or less, 100% (95% confidence interval [CI] = 78%-100%) of the cancers would still be detected by age 75 years; if PSA testing were discontinued in men aged 65 years who had PSA levels of 1.0 ng/mL or less, 94% (95% CI = 70%-100%) of the cancers would still be detected by age 75 years. Conclusions: These data suggest that a decrease in the intensity of screening among older men with low PSA values may not lead to an increase in undetected prostate cancer.

Original languageEnglish (US)
Pages (from-to)1733-1737
Number of pages5
JournalJournal of the National Cancer Institute
Volume91
Issue number20
DOIs
StatePublished - Oct 20 1999
Externally publishedYes

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Prostate-Specific Antigen
Prostatic Neoplasms
Neoplasms
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Carter, H. B., Landis, P. K., Metter, E., Fleisher, L. A., & Pearson, J. D. (1999). Prostate-specific antigen testing of older men. Journal of the National Cancer Institute, 91(20), 1733-1737. https://doi.org/10.1093/jnci/91.20.1733

Prostate-specific antigen testing of older men. / Carter, H. Ballentine; Landis, Patricia K.; Metter, E.; Fleisher, Lee A.; Pearson, Jay D.

In: Journal of the National Cancer Institute, Vol. 91, No. 20, 20.10.1999, p. 1733-1737.

Research output: Contribution to journalArticle

Carter, HB, Landis, PK, Metter, E, Fleisher, LA & Pearson, JD 1999, 'Prostate-specific antigen testing of older men', Journal of the National Cancer Institute, vol. 91, no. 20, pp. 1733-1737. https://doi.org/10.1093/jnci/91.20.1733
Carter, H. Ballentine ; Landis, Patricia K. ; Metter, E. ; Fleisher, Lee A. ; Pearson, Jay D. / Prostate-specific antigen testing of older men. In: Journal of the National Cancer Institute. 1999 ; Vol. 91, No. 20. pp. 1733-1737.
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abstract = "Background: Elevated serum prostate-specific antigen (PSA) levels are predictive of a future diagnosis of prostate cancer. To test the hypothesis that older men with low PSA levels may require less intensive PSA testing because of a reduced prostate cancer detection rate, we evaluated the association between age, baseline PSA level, and prostate cancer detection. Methods: We conducted a prospective cohort study among participants in a study of aging who had serial PSA measurements taken from age 60 or 65 years until they either were diagnosed with prostate cancer (cancer case subjects) or reached the age of 75 years (subjects without prostate cancer). The time of cancer detection among cancer case subjects was defined as the measurement date on which a PSA level above 4.0 ng/mL was detected (i.e., PSA conversion). Cancer case subjects and subjects without prostate cancer were analyzed according to baseline PSA level and age. Results: All cancer case subjects in the 60-year-old cohort had baseline PSA levels above 0.5 ng/mL, and 14 of 15 cancer cases that would have been detected by a PSA conversion among the 65-year-old cohort were associated with baseline PSA levels of 1.1 ng/mL or more. If PSA testing were discontinued in men aged 65 years with PSA levels of 0.5 ng/mL or less, 100{\%} (95{\%} confidence interval [CI] = 78{\%}-100{\%}) of the cancers would still be detected by age 75 years; if PSA testing were discontinued in men aged 65 years who had PSA levels of 1.0 ng/mL or less, 94{\%} (95{\%} CI = 70{\%}-100{\%}) of the cancers would still be detected by age 75 years. Conclusions: These data suggest that a decrease in the intensity of screening among older men with low PSA values may not lead to an increase in undetected prostate cancer.",
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