- To evaluate the validity of prostate-specific antigen (PSA) in identifying men who subsequently were or were not clinically diagnosed with prostate cancer, assess optimal test cutoff, measure lead time, and estimate relative risks (RRs) associated with discrete PSA levels.
- Nested case-control study of men providing plasma samples before a 10-year follow-up.
- The Physicians'Health Study, an ongoing randomized trial that enrolled 22 071 men aged 40 to 84 years in 1982.
- A total of 366 men (cases) diagnosed with prostate cancer and 1098 men (three controls per case), matched by age, randomly selected from all cohort members at risk at the time of case diagnosis. - Sensitivity and specificity for each year of follow-up and for aggressive and nonaggressive cancers separately.
- At a cutoff of 4.0 ng/mL, sensitivity for the entire 10-year follow-up was 46% for total cases.
Sensitivities for detection of total, aggressive, and nonaggressive cancers occurring in the first 4 years were 73%, 87%, and 53%. Overall, specificity was 91% and changed little by year of follow-up.
Optimal validity was achieved at a cutoff of 3.3 ng/mL.
Estimated mean lead time for all cancers was 5.5 years.
Only 40% of cancers detected more than 5 years from baseline were nonaggressive.
Compared with men with PSA levels less than 1.0 ng/mL, those with PSA levels between 2.0 and 3.0 ng/mL had an RR of 5.5 (95% confidence interval, 3.7 to 9.2).
Mots-clés Pascal : Appareil urinaire pathologie, Tumeur maligne, Dépistage, Homme, Etude comparative, Prostate, Prostate pathologie, Etats Unis, Amérique du Nord, Amérique, Etude longitudinale, Antigène PSA
Mots-clés Pascal anglais : Urinary system disease, Malignant tumor, Medical screening, Human, Comparative study, Prostate, Prostate disease, United States, North America, America, Follow up study, Prostate specific antigen
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0191204
Code Inist : 002B24O07. Création : 09/06/1995.