A randomized screening trial was started in Europe to show the effect of early detection and treatment of prostate cancer on mortality (European Study on Screening of Prostate Cancer).
In one centre (Rotterdam), the screening protocol initially consisted of 3 screening tests for all men : prostate-specific antigen (PSA), digital rectal examination (DRE) and transrectal ultrasonography (TRUS).
A PSA value of >=4 ng/ml andlor an abnormality on DRE andlor TRUS were taken to indicate that biopsy was required.
In this study, we examined the possibilities for a more efficient screening protocol.
A logistic-regression model was used to predict the number of cancers for PSA<4 ng/ml if all men were biopsied (predictive index, PI).
Effects of a change in PSA cut-off on the screening results were explored.
Weights were applied to procedures and cancers to explore the possibility of expressing differences between protocols in one overall figure.
Biopsies in men with PSA
Applying DRE and TRUS only in the PSA ranges 1.5 to 3.9 and 2 to 3.9 ng/ml to determine whether a biopsy was required would result in a decrease of 29 to 36% in biopsies and a decrease of 5 to 8% in cancers.
However, the results of DRE and TRUS could not be duplicated entirely.
A protocol with only PSA >= 3 ng/ml as a direct biopsy indicator resulted in a decrease of detected cancers by 7.6% and of biopsies by 12%, also a much simpler screening procedure. (...)
Mots-clés Pascal : Tumeur maligne, Prostate, Antigène spécifique prostate, Toucher rectal, Evaluation, Echographie, Dépistage, Pays Bas, Europe, Homme, Appareil génital mâle pathologie, Appareil urinaire pathologie, Prostate pathologie, Exploration ultrason, Voie transrectale
Mots-clés Pascal anglais : Malignant tumor, Prostate, Prostate specific antigen, Rectal touch, Evaluation, Echography, Medical screening, Netherlands, Europe, Human, Male genital diseases, Urinary system disease, Prostate disease, Sonography
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0387107
Code Inist : 002B14D02. Création : 22/03/2000.