Prostate Cancer Incidence and Mortality Following a Negative Biopsy in a Population Undergoing PSA Screening - 03/09/21
Abstract |
Objective |
Transrectal ultrasound guided biopsy for diagnostic workup for prostate cancer (PCa) has a substantial false negative rate. We sought to estimate PCa incidence and mortality following negative biopsy in a cohort of men undergoing prostate cancer screening.
Subjects and Methods |
The Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial randomized participants 55-74 years to an intervention vs control arm. Intervention arm men received annual prostate-specific antigen (PSA) tests for 6 years and digital rectal exams (DRE) for 4 years. We examined the cohort of men with a positive PSA (> 4 ng/mL) or DRE screen followed within one year by a negative biopsy. PCa incidence and mortality rates from time of first negative biopsy were analyzed as a function of PSA level at diagnosis and other factors. Cumulative incidence and mortality rates accounting for competing risk were estimated. Multivariate proportional hazards regression was utilized to estimate hazard ratios (HRs) of PCa outcomes by PSA level, controlling for age and race.
Results |
The negative biopsy cohort included 2855 men. Median (25th/75th) age at biopsy was 65 (61/69) years; biopsies occurred between 1994 and 2006. Median (25/75th) follow-up was 13.2 (6.5/16.8) years for incidence and 16.6 (12.3/19.2) years for mortality. 740 PCa cases were diagnosed, with 33 PCa deaths. Overall 20-year cumulative PCa incidence and mortality rates were 26.4% (95% CI: 24.8-28.1) and 1.2% (95% CI: 0.9-1.7), respectively. HRs for PCa incidence and mortality increased significantly with increasing PSA.
Conclusion |
The mortality rate from PCa through 20 years following a negative biopsy is low.
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| Financial Disclosure: The authors report no conflicts of interest. |
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| Funding Support: Cancer incidence data have been provided by the following state cancer registries: Alabama, Arizona, California, Colorado, District of Columbia, Hawaii, Idaho, Maryland, Michigan, Minnesota, Missouri, Nevada, Ohio, Pennsylvania, Texas, Utah, Virginia and Wisconsin. All are supported in part by funds from the Centers for Disease Control and Prevention, National Program for Central Registries, local states, or by the National Cancer Institute, Surveillance, Epidemiology, and End Results Program. The results reported here and the conclusions derived are the sole responsibility of the authors. |
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| HCA Disclaimer This research was supported in part by HCA Healthcare and an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities. |
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| NIH Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health. |
Vol 155
P. 62-69 - septembre 2021 Retour au numéro
Article précédent
- Patient Preferences and Treatment Decisions for Prostate Cancer: Results From A Statewide Urological Quality Improvement Collaborative
- Roshan Paudel, Stephanie Ferrante, Ji Qi, Rodney L. Dunn, Donna L. Berry, Alice Semerjian, Christopher M. Brede, Arvin K. George, Brian R. Lane, Kevin B. Ginsburg, James E. Montie, Giulia I. Lane, for the Michigan Urological Surgery Improvement Collaborative
- EDITORIAL COMMENT
- Peter C. Albertsen
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