This study aimed to determine if lower serum total prostate-specific antigen （PSA） levels in obese Korean men affect prostate cancer （PCa） screening, as an increased body mass index （BMI） is inversely associated...This study aimed to determine if lower serum total prostate-specific antigen （PSA） levels in obese Korean men affect prostate cancer （PCa） screening, as an increased body mass index （BMI） is inversely associated with the PSA level. Between March 2007 and December 2012, 22 208 native Korean men who were eligible to receive a serum PSA test were recruited. Logistic regression was used to estimate the odds of an ＇abnormal＇ PSA （ ≥ 2.5 or/〉 4.0 ng ml^- 1） in these men （age： 45-75 years, PSA 〈 10 ng ml^-1） based on BMI, which was categorized as normal （BMI 〈25 kg m^-2） and obese （BMI i〉 25 kg m-2）. In all, 20 509 men （92.3%） were included in the study after applying the inclusion criteria. After controlling for age, there was a statistically significant trend towards a lower likelihood of having a serum PSA level ≥ 2.5 ng ml^-1 with an increased BMI, with obese men having an 18% lower likelihood （odds ratio： 0.823, 95% confidence interval： 0.743-0.912; P〈0.001） compared to men with a normal BMI. Obese men were approximately 82% as likely to have a PSA level ≥ 2.5 ng ml^-2 as men with a normal BMI. These results might affect PCa screening using serum total PSA. Further studies are needed to better define these results in clinical biopsy practice.展开更多
Background: Prostate cancer is the most common type of cancer among Nigerian men. Prostate specific antigen (PSA) is produced by the prostate gland and it is an important tumor marker in the screening and diagnosis of...Background: Prostate cancer is the most common type of cancer among Nigerian men. Prostate specific antigen (PSA) is produced by the prostate gland and it is an important tumor marker in the screening and diagnosis of prostate cancer because the latter is often associated with elevated PSA levels. The aim of this study was to evaluate the profile and PSA levels of men presenting for prostate cancer screening at the National Obstetric Fistula Centre, Abakaliki, Nigeria. Methods: This was a retrospective study of 103 patients who were seen between January 2014 and December 2015 and screened for prostate cancer using PSA assay. Data was extracted from folders of patients using a proforma and analysed using the Statistical Package for Social Sciences (SPSS), version 21. Result: Out of the 103 clients studied, 67 (65%) were between the ages of 40 and 59 years. The mean age was 54.38 ± 12.5 years. Eighty-one (78.6%) of the study population had PSA levels 4 ng/ml and below, 5 (4.9%) had PSA levels of 4.1 - 10 ng/ml, while 17 (16.5%) had PSA levels > 10 ng/ml. The mean PSA was 4.75 ± 8.2 ng/ml. None of the patients with family history of cancer had PSA levels of >4 ng/ml. Those who were positive for HIV also had normal PSA results. Conclusion: The findings from this study showed that the prevalence of men with raised PSA (>4 ng/ml) was high (21.4%) especially in the 60 - 69 years age group. There is need to increase prostate cancer screening using PSA in our setting. The use of other parameters such as digital rectal examination, PSA density, PSA velocity and free PSA will be helpful to determine the need for histological diagnosis in these patients.展开更多
Prostate cancer is the most common intrinsic cancer in men and the 2nd most common cause of cancer related death in men over fifty years of age. The benefit of early screening for prostate cancer is yet to be proven. ...Prostate cancer is the most common intrinsic cancer in men and the 2nd most common cause of cancer related death in men over fifty years of age. The benefit of early screening for prostate cancer is yet to be proven. Multiple organizations currently offer recommendations regarding prostate cancer screening. Prostate Specific Antigen (PSA) testing was introduced into widespread use in the late 80’s and its role in screening is debatable. We surveyed by mail every primary care physician in West Virginia who has a state license. Results from 438 respondents indicated that the American Cancer Society (ACS) guidelines were most commonly used and that PSA testing does seem to be a good screening test. We present the results and discuss the different points of view regarding prostate cancer screening.展开更多
目的探讨社区群体性早筛联合双向转诊模式相较传统就诊机会性筛查模式在诊断早期前列腺癌的差异性。方法2022年8月~2024年4月对复旦大学附属上海市第五人民医院康联体内的5家社区卫生服务中心的高危老年男性开展前列腺特异性抗原(prosta...目的探讨社区群体性早筛联合双向转诊模式相较传统就诊机会性筛查模式在诊断早期前列腺癌的差异性。方法2022年8月~2024年4月对复旦大学附属上海市第五人民医院康联体内的5家社区卫生服务中心的高危老年男性开展前列腺特异性抗原(prostate specific antigen,PSA)群体性筛查共计12815人,发现PSA>4.0ng/ml的异常患者共1005例,采取双向转诊模式到复旦大学附属上海市第五人民医院进一步评估,符合指征同意穿刺者予以活检,前列腺活检数445例,平均年龄为65.6±6.8岁,收集临床资料,记为社区群体性早筛联合双向转诊模式组(A组);同期对因下尿路症状就诊于复旦大学附属上海市第五人民医院的高危老年男性开展PSA的机会性筛查模式共计4600人,PSA异常者700例,进一步评估符合指征同意穿刺者予以活检,前列腺活检数270例,平均年龄为64.8±6.4岁,收集临床资料,记为传统就诊机会性筛查模式组(B组)。比较两组患者的基线特征及前列腺癌阳性率、临床分期及病理分级。结果两组患者的年龄、PSA水平、家族史、体重指数(body mass index,BMI)、婚姻状态及教育程度等比较,差异均无统计学意义(P>0.05);A组阳性例数为160例,癌症阳性率为35.9%,B组阳性例数为90例,癌症阳性率为33.3%,两组比较差异无统计学意义(P=0.652);A组临床分期≤T_(2)N_(0)M_(0)期例数为100例,在本组确诊例数占比62.5%,B组临床分期≤T_(2)N_(0)M_(0)期例数为35例,在本组确诊例数占比38.9%,两组比较差异有统计学意义(P=0.023);A组国际泌尿病理学会(International Society of Urological Pathology,ISUP)分级≤3级例数为105例,在本组确诊例数占比65.6%,B组病理分级ISUP分级≤3级例数为30例,在本组确诊例数占比33.3%,两组比较差异有统计学意义(P=0.002)。结论社区群体性早筛联合双向转诊模式相较传统就诊机会性筛查模式在前列腺癌阳性率方面未见差异,但在诊断早期前列腺癌方面具有优势,该模式进一步推广有望改善我国前列腺癌患者分期偏晚、总体预后差的现状。展开更多
Prostate cancer （PCa） is one of the most common cancers among men in Western developed countries and its incidence has increased considerably in many other parts of the world, including China. The etiology of PCa is...Prostate cancer （PCa） is one of the most common cancers among men in Western developed countries and its incidence has increased considerably in many other parts of the world, including China. The etiology of PCa is largely unknown but is thought to be multifactorial, where inherited genetics plays an important role. In this article, we first briefly review results from studies of familial aggregation and genetic susceptibility to PCa. We then recap key findings of rare and high-penetrance PCa susceptibility genes from linkage studies in PCa families. We devote a significant portion of this article to summarizing discoveries of common and Iow-penetrance PCa risk-associated single-nucleotide polymorphisms （SNPs） from genetic association studies in PCa cases and controls, especially those from genome-wide association studies （GWASs）. A strong focus of this article is to review the literature on the potential clinical utility of these implicated genetic markers. Most of these published studies described PCa risk estimation using a genetic score derived from multiple risk-associated SNPs and its utility in determining the need for prostate biopsy. Finally, we comment on the newly proposed concept of genetic score; the notion is to treat it as a marker for genetic predisposition, similar to family history, rather than a diagnostic marker to discriminate PCa patients from non-cancer patients. Available evidence to date suggests that genetic score is an objective and better measurement of inherited risk of PCa than family history. Another unique feature of this article is the inclusion of genetic association studies of PCa in Chinese and Japanese populations.展开更多
文摘This study aimed to determine if lower serum total prostate-specific antigen （PSA） levels in obese Korean men affect prostate cancer （PCa） screening, as an increased body mass index （BMI） is inversely associated with the PSA level. Between March 2007 and December 2012, 22 208 native Korean men who were eligible to receive a serum PSA test were recruited. Logistic regression was used to estimate the odds of an ＇abnormal＇ PSA （ ≥ 2.5 or/〉 4.0 ng ml^- 1） in these men （age： 45-75 years, PSA 〈 10 ng ml^-1） based on BMI, which was categorized as normal （BMI 〈25 kg m^-2） and obese （BMI i〉 25 kg m-2）. In all, 20 509 men （92.3%） were included in the study after applying the inclusion criteria. After controlling for age, there was a statistically significant trend towards a lower likelihood of having a serum PSA level ≥ 2.5 ng ml^-1 with an increased BMI, with obese men having an 18% lower likelihood （odds ratio： 0.823, 95% confidence interval： 0.743-0.912; P〈0.001） compared to men with a normal BMI. Obese men were approximately 82% as likely to have a PSA level ≥ 2.5 ng ml^-2 as men with a normal BMI. These results might affect PCa screening using serum total PSA. Further studies are needed to better define these results in clinical biopsy practice.
文摘Background: Prostate cancer is the most common type of cancer among Nigerian men. Prostate specific antigen (PSA) is produced by the prostate gland and it is an important tumor marker in the screening and diagnosis of prostate cancer because the latter is often associated with elevated PSA levels. The aim of this study was to evaluate the profile and PSA levels of men presenting for prostate cancer screening at the National Obstetric Fistula Centre, Abakaliki, Nigeria. Methods: This was a retrospective study of 103 patients who were seen between January 2014 and December 2015 and screened for prostate cancer using PSA assay. Data was extracted from folders of patients using a proforma and analysed using the Statistical Package for Social Sciences (SPSS), version 21. Result: Out of the 103 clients studied, 67 (65%) were between the ages of 40 and 59 years. The mean age was 54.38 ± 12.5 years. Eighty-one (78.6%) of the study population had PSA levels 4 ng/ml and below, 5 (4.9%) had PSA levels of 4.1 - 10 ng/ml, while 17 (16.5%) had PSA levels > 10 ng/ml. The mean PSA was 4.75 ± 8.2 ng/ml. None of the patients with family history of cancer had PSA levels of >4 ng/ml. Those who were positive for HIV also had normal PSA results. Conclusion: The findings from this study showed that the prevalence of men with raised PSA (>4 ng/ml) was high (21.4%) especially in the 60 - 69 years age group. There is need to increase prostate cancer screening using PSA in our setting. The use of other parameters such as digital rectal examination, PSA density, PSA velocity and free PSA will be helpful to determine the need for histological diagnosis in these patients.
文摘Prostate cancer is the most common intrinsic cancer in men and the 2nd most common cause of cancer related death in men over fifty years of age. The benefit of early screening for prostate cancer is yet to be proven. Multiple organizations currently offer recommendations regarding prostate cancer screening. Prostate Specific Antigen (PSA) testing was introduced into widespread use in the late 80’s and its role in screening is debatable. We surveyed by mail every primary care physician in West Virginia who has a state license. Results from 438 respondents indicated that the American Cancer Society (ACS) guidelines were most commonly used and that PSA testing does seem to be a good screening test. We present the results and discuss the different points of view regarding prostate cancer screening.
文摘目的探讨社区群体性早筛联合双向转诊模式相较传统就诊机会性筛查模式在诊断早期前列腺癌的差异性。方法2022年8月~2024年4月对复旦大学附属上海市第五人民医院康联体内的5家社区卫生服务中心的高危老年男性开展前列腺特异性抗原(prostate specific antigen,PSA)群体性筛查共计12815人,发现PSA>4.0ng/ml的异常患者共1005例,采取双向转诊模式到复旦大学附属上海市第五人民医院进一步评估,符合指征同意穿刺者予以活检,前列腺活检数445例,平均年龄为65.6±6.8岁,收集临床资料,记为社区群体性早筛联合双向转诊模式组(A组);同期对因下尿路症状就诊于复旦大学附属上海市第五人民医院的高危老年男性开展PSA的机会性筛查模式共计4600人,PSA异常者700例,进一步评估符合指征同意穿刺者予以活检,前列腺活检数270例,平均年龄为64.8±6.4岁,收集临床资料,记为传统就诊机会性筛查模式组(B组)。比较两组患者的基线特征及前列腺癌阳性率、临床分期及病理分级。结果两组患者的年龄、PSA水平、家族史、体重指数(body mass index,BMI)、婚姻状态及教育程度等比较,差异均无统计学意义(P>0.05);A组阳性例数为160例,癌症阳性率为35.9%,B组阳性例数为90例,癌症阳性率为33.3%,两组比较差异无统计学意义(P=0.652);A组临床分期≤T_(2)N_(0)M_(0)期例数为100例,在本组确诊例数占比62.5%,B组临床分期≤T_(2)N_(0)M_(0)期例数为35例,在本组确诊例数占比38.9%,两组比较差异有统计学意义(P=0.023);A组国际泌尿病理学会(International Society of Urological Pathology,ISUP)分级≤3级例数为105例,在本组确诊例数占比65.6%,B组病理分级ISUP分级≤3级例数为30例,在本组确诊例数占比33.3%,两组比较差异有统计学意义(P=0.002)。结论社区群体性早筛联合双向转诊模式相较传统就诊机会性筛查模式在前列腺癌阳性率方面未见差异,但在诊断早期前列腺癌方面具有优势,该模式进一步推广有望改善我国前列腺癌患者分期偏晚、总体预后差的现状。
基金This work was partially funded by the National Key Basic Research Program Grant 973 （No.2012CB518301） to JX, the Key Project of the National Natural Science Foundation of China （No.81130047） to IX, intramural grants from Fudan University ＇Thousand Talents Program＇ and Huashan Hospital to JX and the National Institutes of Health （No.NCI CA129684） to IX.
文摘Prostate cancer （PCa） is one of the most common cancers among men in Western developed countries and its incidence has increased considerably in many other parts of the world, including China. The etiology of PCa is largely unknown but is thought to be multifactorial, where inherited genetics plays an important role. In this article, we first briefly review results from studies of familial aggregation and genetic susceptibility to PCa. We then recap key findings of rare and high-penetrance PCa susceptibility genes from linkage studies in PCa families. We devote a significant portion of this article to summarizing discoveries of common and Iow-penetrance PCa risk-associated single-nucleotide polymorphisms （SNPs） from genetic association studies in PCa cases and controls, especially those from genome-wide association studies （GWASs）. A strong focus of this article is to review the literature on the potential clinical utility of these implicated genetic markers. Most of these published studies described PCa risk estimation using a genetic score derived from multiple risk-associated SNPs and its utility in determining the need for prostate biopsy. Finally, we comment on the newly proposed concept of genetic score; the notion is to treat it as a marker for genetic predisposition, similar to family history, rather than a diagnostic marker to discriminate PCa patients from non-cancer patients. Available evidence to date suggests that genetic score is an objective and better measurement of inherited risk of PCa than family history. Another unique feature of this article is the inclusion of genetic association studies of PCa in Chinese and Japanese populations.
