Serum prostate-specific antigen and digital rectal examination for early detection of prostate cancer in a national community-based program.
This study analyzed methods of prostate cancer early detection in community settings throughout the United States against standards and findings of earlier studies conducted at academic medical centers.
The study was conducted at 148 clinical centers during Prostate Cancer Awareness Week in September 1993 and continued through June 1994.
A total of 31,953 eligible subjects were tested by both digital rectal examination (DRE) and prostate-specific antigen (PSA).
PSA was tested with the Abbott IMx PSA assay and reported by Roche Biomedical, Inc.
The study confirmed that elevated PSA levels (greater than 4.0 ng/mL) aid in the detection of organ-confined prostate cancer when used in conjunction with the DRE.
Reflecting more conservative biopsy decision-making practices, study results nonetheless are comparable to earlier reports.
Among 1307 subjects who underwent biopsy, 322 cancers were detected.
The cancer detection rate was 3.6% for PSA, 3.0% for DRE, and 4.7% if either test result was positive.
The positive predictive value (PPV) for elevated PSA levels (greater than 4.0 ng/mL) was 31.6%, significantly better (P<0.0001) than the PPV for abnormal DRE results (25.5%). Nearly 90% (88.9%) of staged cancers were diagnosed as localized.
Elevated PSA levels detected more localized cancers (76 of 105 [72.4% ]) than the DRE (72 of 105 168.6% ]). Of localized tumors, 33 (31.4%) were missed by DRE and detected solely by PSA, and 29 (27. (...)
Mots-clés Pascal : Adénocarcinome, Prostate, Homme, Diagnostic, Stade précoce, Antigène spécifique prostate, Sérum, Toucher rectal, Etude multicentrique, Echelon national, Etats Unis, Amérique du Nord, Amérique, Sensibilité, Valeur prédictive, Dépistage, Tumeur maligne, Appareil urinaire pathologie, Appareil génital mâle pathologie, Prostate pathologie
Mots-clés Pascal anglais : Adenocarcinoma, Prostate, Human, Diagnosis, Early stage, Prostate specific antigen, Serum, Rectal touch, Multicenter study, National scope, United States, North America, America, Sensitivity, Predictive value, Medical screening, Malignant tumor, Urinary system disease, Male genital diseases, Prostate disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0320206
Code Inist : 002B14D02. Création : 10/04/1997.