Detection of subclinical cancers by prostate-specific antigen screening in asymptomatic men from high-risk prostate cancer families.

Abstract

Positive family history is a significant risk factor for prostate cancer. Improved knowledge of the epidemiology and molecular basis of hereditary prostate cancer has led to a need for counseling and clinical follow-up for men with a positive family history of prostate cancer. However, very little information is available on the efficacy of early screening procedures, such as serum prostate-specific antigen (PSA) measurements, in the management of genetically predisposed, high-risk individuals. In a nationwide study, we obtained family histories from 2099 Finnish prostate cancer patients and identified 302 families with two or more affected cases. Here, 209 asymptomatic 45-75-year-old males from these families were included in a study to determine the frequency of serum PSA positivity and the prevalence of subclinical prostate cancers. Serum PSA was elevated in 21 (10.0%) of these high-risk individuals. Seven prostate cancers (3.3%) and two high-grade prostatic intraepithelial neoplasia lesions were diagnosed, with three cancers occurring in men ages < or = 59 years. Men from prostate cancer families with an average age of onset of < 60 years had a significantly higher frequency of PSA positivity (28.6%, P = 0.01) as well as cancers (14.3%, P = 0.02) than those with a later age of onset. The results suggest that prostate cancer development in genetically predisposed individuals is preceded by a subclinical period when PSA detection is possible. Serum PSA screening may be particularly useful in men with a family history of early-onset prostate cancer.

• Authors: M P Matikainen, J Schleutker, P Mörsky, O P Kallioniemi, T L Tammela
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 5 Issue 6 Pg. 1275-9 (Jun 1999) ISSN: 1078-0432 [Print] United States
• PMID: 10389909 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Prostate-Specific Antigen

Topics

• Adenocarcinoma (blood, diagnosis, epidemiology, genetics)
• Age of Onset
• Aged
• Genetic Predisposition to Disease
• Humans
• Male
• Middle Aged
• Pedigree
• Predictive Value of Tests
• Prevalence
• Prostate-Specific Antigen (blood)
• Prostatic Neoplasms (blood, diagnosis, epidemiology, genetics)
• Sensitivity and Specificity