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Tesfai A, Norori N, Harding TA, Wong YH, Hobbs MD. Variation in harms and benefits of prostate-specific antigen screening for prostate cancer by socio-clinical risk factors: A rapid review. BJUI COMPASS 2024; 5:417-432. [PMID: 38751945 PMCID: PMC11090766 DOI: 10.1002/bco2.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/25/2023] [Indexed: 05/18/2024] Open
Abstract
Objective To analyse the latest evidence on the relative harms and benefits of screening and diagnostic pathways with close examination of (i) men aged 50 years or older, (ii) men whose ethnicity places them at higher risk and (iii) men with a family history. Methods We conducted a literature search using PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) databases and other sources, from January 1990 to 25 January 2023. Two independent reviewers selected for randomised controlled trials (RCTs) and cohort studies which met our inclusion criteria. Results Twenty-eight articles were selected, from six trials, including the Göteborg trial-reported separately from European Randomised Study of Screening for Prostate Cancer (ERSPC). Prostate-specific antigen (PSA)-based screening led to the increased detection of low-grade cancer and reduction of advanced/metastatic disease but had contradictory effects on prostate cancer (PCa)-specific mortality (no difference or reduced), possibly due to issues of contamination or compliance. Screening men from a relatively young age (50-55) reduced risk of PCa-specific mortality in a subanalysis of an 18-year follow-up study and in a 17-year cohort study from the main Göteborg trial. Moreover, one Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial analysis reported a trend of reduced risk of PCa-specific mortality for men with a family history who were screened. [Correction added on 05 March 2024, after first online publication: "Cancer Screening Trial" has been added to the preceding sentence.] However, we did not find relevant studies for ethnicity. Conclusion Under current UK practice, the choice to conduct a PSA test relies on a shared decision-making approach guided by known risk factors. However, we found there was a lack of strong evidence on the harms and benefits of PSA screening by socio-clinical risk factors and suggest further research is required to understand the long-term impact of screening on high-risk populations in the current diagnostic setting.
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Amini AE, Salari K. Incorporating Genetic Risk Into Prostate Cancer Care: Implications for Early Detection and Precision Oncology. JCO Precis Oncol 2024; 8:e2300560. [PMID: 38412389 DOI: 10.1200/po.23.00560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/12/2023] [Accepted: 01/08/2024] [Indexed: 02/29/2024] Open
Abstract
The availability and cost of germline and somatic genetic testing have dramatically improved over the past two decades, enabling precision medicine approaches in oncology, with significant implications for prostate cancer (PCa) care. Roughly 12% of individuals with advanced disease are carriers of rare pathogenic germline variants that predispose to particularly aggressive and earlier-onset disease. Several of these variants are already established as clinically actionable by modern precision oncology therapeutics, while others may come to aid the selection of active surveillance, definitive local therapies, and systemic therapies. Concurrently, the number of common variants (ie, incorporated into polygenic risk scores) associated with PCa risk has continued to grow, but with several important considerations both at the intersection of race and ancestry and for early detection of aggressive disease. Family history has historically been used as a proxy for this inherited genetic risk of PCa, but recently emerging evidence examining this relation has shifted our understanding of how best to leverage this tool in PCa care. This review seeks to clarify and contextualize the existing and emerging precision oncology paradigms that use inherited genetic risk in PCa care, for both early detection and localized disease management.
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Affiliation(s)
- Andrew E Amini
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Keyan Salari
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA
- Broad Institute of MIT and Harvard, Cambridge, MA
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Mumuni S, O’Donnell C, Doody O. The Risk Factors and Screening Uptake for Prostate Cancer: A Scoping Review. Healthcare (Basel) 2023; 11:2780. [PMID: 37893854 PMCID: PMC10606491 DOI: 10.3390/healthcare11202780] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/11/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVES The purpose of this scoping review was to identify the risk factors and screening uptake for prostate cancer. DESIGN Scoping review. METHODS Arksey and O'Malley's framework guided this review; five databases (Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Academic Search Complete and Cochrane Library) and grey literature were searched. Screening was undertaken against predetermined inclusion criteria for articles published before July 2023 and written in English. This review is reported in line with PRISMA-Sc. RESULTS 10,899 database results were identified; 3676 papers were removed as duplicates and 7115 papers were excluded at title and abstract review. A total of 108 papers were full-text reviewed and 67 were included in the review. Grey literature searching yielded no results. Age, family history/genetics, hormones, race/ethnicity, exposure to hazards, geographical location and diet were identified as risk factors. Prostatic antigen test (PSA), digital rectal examination (DRE), transrectal ultrasound (TRUS), magnetic resonance imaging (MRI), magnetic resonance spectroscopic imaging (MRSI) and prostate biopsy were identified as screening/diagnostic methods. The evidence reviewed highlights moderate knowledge and screening uptake of prostate cancer with less than half of men reporting for PSA screening. On the other hand, there is a year-to-year increase in PSA and DRE screening, but factors such as poverty, religion, culture, communication barriers, language and costs affect men's uptake of prostate cancer screening. CONCLUSION As prostate cancer rates increase globally, there is a need for greater uptake of prostate cancer screening and improved health literacy among men and health workers. There is a need to develop a comprehensive prostate cancer awareness and screening programme that targets men and addresses uptake issues so as to provide safe, quality care. STRENGTHS AND LIMITATIONS OF THIS STUDY (1) A broad search strategy was utilised incorporating both databases and grey literature. (2) The PRISMA reporting guidelines were utilised. (3) Only English language papers were included, and this may have resulted in relevant articles being omitted.
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Affiliation(s)
- Seidu Mumuni
- Department of Nursing and Midwifery, University of Limerick, V94 T9PX Limerick, Ireland; (S.M.); (C.O.)
| | - Claire O’Donnell
- Department of Nursing and Midwifery, University of Limerick, V94 T9PX Limerick, Ireland; (S.M.); (C.O.)
- Health Research Institute, Department of Nursing and Midwifery, University of Limerick, V94 T9PX Limerick, Ireland
| | - Owen Doody
- Health Research Institute, Department of Nursing and Midwifery, University of Limerick, V94 T9PX Limerick, Ireland
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Oh M, McBride A, Bhattacharjee S, Slack M, Jeter J, Abraham I. Economic value of knowing BRCA status: BRCA testing for prostate cancer prevention and optimal treatment. Expert Rev Pharmacoecon Outcomes Res 2023; 23:297-307. [PMID: 36649640 DOI: 10.1080/14737167.2023.2169137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND We aimed to estimate the incremental lifetime effects, costs, and net-monetary-benefit (NMB) of knowing BRCA information by testing of patients with low-risk localized prostate cancer (PCa) in the US and guiding subsequent screening and treatment, and the cumulative savings or losses of yearly cohort testing over 16 years. We compared two strategies: (1)'with BRCA information' and (2)'without BRCA information.' We also estimated the expected value of perfect information. METHODS The incremental NMB (INMB) quantified the monetized benefit per person of knowing BRCA status. The net-monetized-value of knowing BRCA information was estimated by multiplying the INMB with the eligible population. RESULTS The INMBs of knowing BRCA information were $43,357 (payer) and $43,487 (society). in payer and societal perspectives, respectively. Escalated to the eligible patients in 2020, knowing BRCA status resulted in net monetized lifetime value of $1.7 billion (payer and society) for the 2020 cohort; and yielded accumulated net-monetized-value of $28.0 billion (payer) and $28.1 billion (society) over 16 yearly cohorts of eligible PCa patients. CONCLUSIONS The economic value of knowing BRCA status for all low-risk localized PCa patients in the US provides short-term and long-term evidence for BRCA testing to screen early and optimize treatment.
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Affiliation(s)
- Mok Oh
- College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - Ali McBride
- Cancer Center - North Campus, The University of Arizona, Tucson, AZ, USA
| | | | - Marion Slack
- College of Pharmacy, University of Arizona, Tucson, AZ, USA.,Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - Joanne Jeter
- Health Huntsman Cancer Institute, University of Utah
| | - Ivo Abraham
- Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, AZ, USA
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Baio R, Napodano G, Caruana C, Molisso G, Di Mauro U, Intilla O, Pane U, D'angelo C, Francavilla A, Guarnaccia C, Pentimalli F, Sanseverino R. Association between obesity and frequency of high‑grade prostate cancer on biopsy in men: A single‑center retrospective study. Mol Clin Oncol 2022; 17:127. [PMID: 35832470 PMCID: PMC9264326 DOI: 10.3892/mco.2022.2560] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/24/2022] [Indexed: 11/09/2022] Open
Abstract
The present study aimed to investigate the relationship between BMI and the prostate cancer (PCa) risk at biopsy in Italian men. Retrospective analyses of the clinical data of 2,372 consecutive men undergoing ultrasound-guided multicore (≥10) prostate biopsy transrectally between May 2010 and December 2018 were performed. BMIs were categorized, according to Western countries' classification of obesity, as follows: <18.5 kg/m2 (underweight), 18.5-24.99 kg/m2 (normal weight), 25-30 kg/m2 (overweight) and >30 kg/m2 (obese). The distribution of patients undergoing biopsy was compared with a model population from the official survey data. Patient characteristics and the relationships between characteristics were investigated using correlation analysis, ANOVA, Kruskal-Wallis and Dunn's tests. The present study estimated the influence on cancer incidence not only of BMI but also of other patient characteristics using multi-variable logistic modelling and compared, using the models, the expected outcomes for patients who differed only in BMI. From a sample of 2,372 men, the present study enrolled 1,079 men due to a lack of clinical data [such as prostate specific antigen (PSA) and BMI data] in the other patients undergoing prostate biopsy. Their distribution was significantly different from the model distribution with the probability of undergoing biopsy increasing with increasing BMI. The median age was 69.4 years. The median BMI was 26.4 kg/m2, while the median PSA level was 7.60 ng/ml. In total, the biopsies detected PCa in 320 men (29.7%) and high-grade PCa (HGPCa) in 218 men (20.2%). Upon applying the aforementioned Western countries' criteria for BMI categories, there were 4 (0.4%) underweight, 318 (29.5%) of normal weight, 546 (50.6%) overweight, and 211 (19.6%) obese patients. ANOVA/Kruskal-Wallis tests revealed that overweight and obese men were younger than the normal-weight men, while there was no statistical difference in their PSA values. Furthermore, 29.3% of normal-weight men, 29.5% of overweight men and 29.9% of obese men were diagnosed with PCa, while 19.5% of normal-weight men, 20.1% of overweight men and 21.8% of obese men were affected by severe cancer. BMI was found to be positively correlated with PCa risk and negatively correlated with both age and PSA level. Age and PSA level were both positively correlated with PCa risk, while digital rectal examination (DRE) outcome was strongly indicative of PCa discovery if the test outcome was positive. Logistics models attributed a positive coefficient to BMI when evaluated against both PCa risk and HGPCa risk. In patients having a negative DRE outcome who differed only in BMI, logistic regression showed a 60% increased risk of PCa diagnosis in obese patients compared with in normal-weight patients. This risk difference increased when other characteristics were less indicative of PCa (younger age/lower PSA), while it decreased when patient characteristics were more indicative (older age/higher PSA, positive DRE). In conclusion, the present study demonstrated that, in men with higher BMIs, the risk of PCa is higher. The relative difference in risk between low and high BMI is most pronounced in younger patients having a lower PSA level and a negative DRE outcome.
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Affiliation(s)
- Raffaele Baio
- Department of Medicine and Surgery ‘Scuola Medica Salernitana’, University of Salerno, Baronissi, I‑84081 Salerno, Italy
| | | | | | - Giovanni Molisso
- Department of Urology, Umberto I Hospital, Nocera, Inferiore, I‑84014 Salerno, Italy
| | - Umberto Di Mauro
- Department of Urology, Umberto I Hospital, Nocera, Inferiore, I‑84014 Salerno, Italy
| | - Olivier Intilla
- Department of Urology, Umberto I Hospital, Nocera, Inferiore, I‑84014 Salerno, Italy
| | - Umberto Pane
- Department of Urology, Umberto I Hospital, Nocera, Inferiore, I‑84014 Salerno, Italy
| | - Costantino D'angelo
- Department of Medical Biotechnologies, University of Siena, I‑53100 Siena, Italy
| | - Antonella Francavilla
- Department of Civil Engineering, University of Salerno, Fisciano, I‑84084 Salerno, Italy
| | - Claudio Guarnaccia
- Department of Civil Engineering, University of Salerno, Fisciano, I‑84084 Salerno, Italy
| | | | - Roberto Sanseverino
- Department of Urology, Umberto I Hospital, Nocera, Inferiore, I‑84014 Salerno, Italy
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de la Calle CM, Bhanji Y, Pavlovich CP, Isaacs WB. The role of genetic testing in prostate cancer screening, diagnosis, and treatment. Curr Opin Oncol 2022; 34:212-218. [PMID: 35238838 DOI: 10.1097/cco.0000000000000823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review provides an overview of the current role of genetic testing in prostate cancer screening, diagnosis, and treatment. RECENT FINDINGS Recent studies have uncovered few but highly penetrant rare pathogenic mutations (RPMs), in genes, such as BRCA2, with strong prostate cancer risk and outcomes associations. Over 260 single nucleotide polymorphisms (SNPs) have also been identified, each associated with small incremental prostate cancer risk and when combined in a polygenic risk score (PRS), they provide strong prostate cancer risk prediction but do not seem to predict outcomes. Tumor tissue sequencing can also help identify actionable somatic mutations in many patients with advanced prostate cancer and inform on their risk of harboring a germline pathogenic mutation. SUMMARY RPM testing, PRS testing, and tumor sequencing all have current and/or potential future roles in personalized prostate cancer care.
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Affiliation(s)
- Claire M de la Calle
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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7
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Toribio-Vázquez C, Gómez Rivas J, Yebes Á, Carrión D, Yagüe Barrado M, Álvarez-Maestro M, Martínez-Piñeiro L. Nuevas estrategias en la toma de decisiones en cáncer de próstata. El papel del Oncotype DX. Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Benafif S, Ni Raghallaigh H, McHugh J, Eeles R. Genetics of prostate cancer and its utility in treatment and screening. ADVANCES IN GENETICS 2021; 108:147-199. [PMID: 34844712 DOI: 10.1016/bs.adgen.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Prostate cancer heritability is attributed to a combination of rare, moderate to highly penetrant genetic variants as well as commonly occurring variants conferring modest risks [single nucleotide polymorphisms (SNPs)]. Some of the former type of variants (e.g., BRCA2 mutations) predispose particularly to aggressive prostate cancer and confer poorer prognoses compared to men who do not carry mutations. Molecularly targeted treatments such as PARP inhibitors have improved outcomes in men carrying somatic and/or germline DNA repair gene mutations. Ongoing clinical trials are exploring other molecular targeted approaches based on prostate cancer somatic alterations. Genome wide association studies have identified >250 loci that associate with prostate cancer risk. Multi-ancestry analyses have identified shared as well as population specific risk SNPs. Prostate cancer risk SNPs can be used to estimate a polygenic risk score (PRS) to determine an individual's genetic risk of prostate cancer. The odds ratio of prostate cancer development in men whose PRS lies in the top 1% of the risk profile ranges from 9 to 11. Ongoing studies are investigating the utility of a prostate cancer PRS to target population screening to those at highest risk. With the advent of personalized medicine and development of DNA sequencing technologies, access to clinical genetic testing is increasing, and oncology guidelines from bodies such as NCCN and ESMO have been updated to provide criteria for germline testing of "at risk" healthy men as well as those with prostate cancer. Both germline and somatic prostate cancer research have significantly evolved in the past decade and will lead to further development of precision medicine approaches to prostate cancer treatment as well as potentially developing precision population screening models.
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Affiliation(s)
- S Benafif
- The Institute of Cancer Research, London, United Kingdom.
| | | | - J McHugh
- The Institute of Cancer Research, London, United Kingdom
| | - R Eeles
- The Institute of Cancer Research, London, United Kingdom
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9
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Author Reply. Urology 2021; 153:361-362. [PMID: 33823172 DOI: 10.1016/j.urology.2021.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 03/30/2021] [Indexed: 11/20/2022]
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10
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[Familial prostate cancer and genetic predisposition]. Urologe A 2021; 60:567-575. [PMID: 33721089 DOI: 10.1007/s00120-021-01491-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Twenty percent of all prostate cancer patients have a positive family history (at least 1 first-degree relative with prostate cancer) and a part of these patients have a genetic predisposition. OBJECTIVES A literature search and analysis of studies investigating incidence, diagnosis, and clinical course of familial compared to sporadic prostate cancer as well as genetic predisposition was performed using PubMed and Embase. RESULTS Risk of prostate cancer depends on number, degree of relationship, and age of onset of affected men in the family. The incidence of familial prostate cancer is higher and the age of diagnosis lower compared to sporadic cases. The clinical course of the disease is comparable, but in individuals with a germline mutation, more intensive therapy is needed due to a more aggressive disease. CONCLUSIONS Crucial for risk assessment is a detailed family history, including creation of a pedigree with cancer family history if necessary. In high-risk families, genetic counselling and annual prostate-specific antigen (PSA) screening beginning at the age of 40 should be performed. Verification of a germline mutation requires more intensive therapy due to more aggressive disease.
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Choi HG, Bang WJ, Jo JK, Oh CY, Shim M, Cho JS. The association between family history of prostate cancer and development of prostate cancer among Korean population: A prospective cohort study using KoGES data. Medicine (Baltimore) 2021; 100:e24757. [PMID: 33607822 PMCID: PMC7899810 DOI: 10.1097/md.0000000000024757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/25/2021] [Indexed: 01/05/2023] Open
Abstract
This study aimed to assess the impact of family history (FH) on prostate cancer (PCa) development among a general Korean population. We conducted a prospective cohort study based on the registry records of 211,789 participants in the database of the Korean Genome and Epidemiology Study from 2001 to 2013. A total of 69,693 men with appropriate records were evaluated by being categorizing into 2 groups; a PCa group (100) and control group (69,593). FH of PCa was also categorized as FH of total, father, or brother. Odds ratios (ORs) of PCa development were calculated by using stratified logistic regression models. The adjusted OR of PCa history of father was 27.7 (95% confidence interval [CI] = 9.7-79.2, P < .001) in PCa patients compared to control, and that of PCa history of brother was 15.8 (95% CI = 3.6-69.6, P < .001). Among the adjusted variables, age (OR, 1.17; 95% CI, 1.14-1.21; P < .001), and hyperlipidemia (OR, 2.25; CI, 1.32-3.84; P = .003) were also identified as significant predictors of PCa development. There was no difference in the impact of FH on PCa development between different age groups at PCa diagnosis (<60 vs ≥60 years). To our knowledge, this study represents the first prospective cohort study based on the registry data of a Korean population showing the significance of FH on PCa development. Additionally, the effect of FH on the early onset of PCa has not been confirmed in our analysis.
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Affiliation(s)
- Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery
- Hallym Data Science Laboratory
| | - Woo Jin Bang
- Department of Urology, Hallym University College of Medicine, Anyang
| | - Jung Ki Jo
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Cheol Young Oh
- Department of Urology, Hallym University College of Medicine, Anyang
| | - Myungsun Shim
- Department of Urology, Hallym University College of Medicine, Anyang
| | - Jin Seon Cho
- Department of Urology, Hallym University College of Medicine, Anyang
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12
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Family history of prostate cancer and prostate tumor aggressiveness in black and non-black men;results from an equal access biopsy study. Cancer Causes Control 2021; 32:337-346. [PMID: 33532986 PMCID: PMC7946692 DOI: 10.1007/s10552-020-01389-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 12/29/2020] [Indexed: 11/18/2022]
Abstract
Purpose To test for racial differences in associations between family history (FH) of prostate cancer (PC) and prostate cancer aggressiveness in a racially diverse equal access population undergoing prostate biopsy. Subjects/patients and methods We prospectively enrolled men undergoing prostate biopsy at the Durham Veterans Administration from 2007 to 2018 and assigned case or control status based on biopsy results. Race and FH of PC were self-reported on questionnaires. Logistic regression was used to test the association between FH and PC diagnosis overall and by tumor aggressiveness [high- (Grade Group 3–5) or low-grade (Grade Group 1–2) vs. no cancer], overall, and stratified by race. Models were adjusted for age and year of consent, race, PSA level, digital rectal exam findings, prostate volume, and previous (negative) biopsy receipt. Results Of 1,225 men, 323 had a FH of PC and 652 men were diagnosed with PC on biopsy. On multivariable analysis, FH was associated with increased odds of high-grade PC in black (OR 1.85, p = 0.041) and all men (OR 1.56, p = 0.057) and was unrelated to overall or low-grade PC diagnosis, overall, or stratified by race (all p ≥ 0.325). In sensitivity analyses among men without a previous biopsy, results were slightly more pronounced. Conclusion In this setting of equal access to care, positive FH of PC was associated with increased tumor aggressiveness in black men, but not non-black men undergoing prostate biopsy. Further research is required to tease apart the contribution of genetics from increased PC awareness potentially influencing screening and biopsy rates in men with FH. Supplementary Information The online version of this article (10.1007/s10552-020-01389-8) contains supplementary material, which is available to authorized users.
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Zhai TS, Hu LT, Ma WG, Chen X, Luo M, Jin L, Zhou Z, Liu X, Kang Y, Kang YX, Zhang JX, Liu H, Lu JY, Yao XD, Ye L. Peri-prostatic adipose tissue measurements using MRI predict prostate cancer aggressiveness in men undergoing radical prostatectomy. J Endocrinol Invest 2021; 44:287-296. [PMID: 32474764 DOI: 10.1007/s40618-020-01294-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/07/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To evaluate the effect of peri-prostatic adipose tissue (PPAT) measurements using preoperative MRI on the prediction of prostate cancer (PCa) aggressiveness in men undergoing radical prostatectomy (RP). METHODS We performed a retrospective study on 179 consecutive patients receiving RP from June 2016 to October 2018. Clinical characteristics were collected. PPAT measurements including peri-prostatic fat area (PPFA) and peri-prostatic fat area to prostate area (PA) ratio (PPFA/PA) were calculated by MRI. Multivariable logistic regression analysis was performed to identify independent predictors of PCa lymph node metastasis (LNM). The predictive performance was estimated through ROC curves. Nomograms were created based on the predictors. RESULTS Pathologic Gleason score positively correlated with digital rectal examination (DRE), PSA, PPFA/PA, P504S, and Ki-67 (all P < 0.05). ROC curves revealed that high PPFA and high PPFA/PA were associated with LNM (both P < 0.05). Multivariate analysis revealed that high PPFA/PA, pathologic Gleason score, pT stage, and Ki-67 were independently predictive of LNM. The nomograms were created and the C-index was 0.945. CONCLUSIONS PPFA/PA is an independent predictor for LNM along with Gleason score, pT stage, and Ki-67. PPFA/PA may help predict LNM in men undergoing RP, thus providing adjunctive information for therapeutic strategy and prognosis.
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Affiliation(s)
- T -S Zhai
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
| | - L -T Hu
- Department of Urology, Karamay Central Hospital, No. 67, Middle Zhungaer Rd., Karamay, 834000, Xinjiang, China
| | - W -G Ma
- Department of Urology, Karamay Central Hospital, No. 67, Middle Zhungaer Rd., Karamay, 834000, Xinjiang, China
- Department of Urology, Tongxin People's Hospital, Tongxin, 751300, Ningxia, China
| | - X Chen
- Department of Urology, Karamay Central Hospital, No. 67, Middle Zhungaer Rd., Karamay, 834000, Xinjiang, China
| | - M Luo
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
| | - L Jin
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
| | - Z Zhou
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
- Department of Urology, First Clinical Medical College, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - X Liu
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
- Department of Urology, Shanghai Putuo District People's Hospital, Tongji University School of Medicine, Shanghai, 200060, China
| | - Y Kang
- The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471000, Henan, China
| | - Y -X Kang
- The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471000, Henan, China
| | - J -X Zhang
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
| | - H Liu
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
| | - J -Y Lu
- Department of Urology, Karamay Central Hospital, No. 67, Middle Zhungaer Rd., Karamay, 834000, Xinjiang, China.
| | - X -D Yao
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China.
| | - L Ye
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China.
- Department of Urology, Karamay Central Hospital, No. 67, Middle Zhungaer Rd., Karamay, 834000, Xinjiang, China.
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14
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Abstract
Improvements in DNA sequencing technology and discoveries made by large scale genome-wide association studies have led to enormous insight into the role of genetic variation in prostate cancer risk. High-risk prostate cancer risk predisposition genes exist in addition to common germline variants conferring low-moderate risk, which together account for over a third of familial prostate cancer risk. Identifying men with additional risk factors such as genetic variants or a positive family history is of clinical importance, as men with such risk factors have a higher incidence of prostate cancer with some evidence to suggest diagnosis at a younger age and poorer outcomes. The medical community remains in disagreement on the benefits of a population prostate cancer screening programme reliant on PSA testing. A reduction in mortality has been demonstrated in many studies, but at the cost of significant amounts of overdiagnosis and overtreatment. Developing targeted screening strategies for high-risk men is currently the subject of investigation in a number of prospective studies. At present, approximately 38% of the familial risk of PrCa can be explained based on published SNPs, with men in the top 1% of the risk profile having a 5.71-fold increase in risk of developing cancer compared with controls. With approximately 170 prostate cancer susceptibility loci now identified in European populations, there is scope to explore the clinical utility of genetic testing and genetic-risk scores in prostate cancer screening and risk stratification, with such data in non-European populations eagerly awaited. This review will focus on both the rare and common germline genetic variation involved in hereditary and familial prostate cancer, and discuss ongoing research in exploring the role of targeted screening in this high-risk group of men.
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15
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Dalela D, Sood A, Keeley J, Rogers C, Menon M, Abdollah F. Generalizability of Prostate-Specific Antigen (PSA) Screening Trials in a "Real World" Setting: A Nationwide Survey Analysis. Urology 2020; 148:1-3. [PMID: 33221417 DOI: 10.1016/j.urology.2020.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Deepansh Dalela
- VUI Center for Outcomes Research, Analytics and Evaluation, Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI
| | - Akshay Sood
- VUI Center for Outcomes Research, Analytics and Evaluation, Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI
| | - Jacob Keeley
- VUI Center for Outcomes Research, Analytics and Evaluation, Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI
| | - Craig Rogers
- VUI Center for Outcomes Research, Analytics and Evaluation, Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI
| | - Mani Menon
- VUI Center for Outcomes Research, Analytics and Evaluation, Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI
| | - Firas Abdollah
- VUI Center for Outcomes Research, Analytics and Evaluation, Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI.
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16
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Rethinking prostate cancer screening: could MRI be an alternative screening test? Nat Rev Urol 2020; 17:526-539. [PMID: 32694594 DOI: 10.1038/s41585-020-0356-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2020] [Indexed: 12/14/2022]
Abstract
In the past decade rigorous debate has taken place about population-based screening for prostate cancer. Although screening by serum PSA levels can reduce prostate cancer-specific mortality, it is unclear whether the benefits outweigh the risks of false-positive results and overdiagnosis of insignificant prostate cancer, and it is not recommended for population-based screening. MRI screening for prostate cancer has the potential to be analogous to mammography for breast cancer or low-dose CT for lung cancer. A number of potential barriers and technical challenges need to be overcome in order to implement such a programme. We discuss different approaches to MRI screening that could address these challenges, including abbreviated MRI protocols, targeted MRI screening, longer rescreening intervals and a multi-modal screening pathway. These approaches need further investigation, and we propose a phased stepwise research framework to ensure proper evaluation of the use of a fast MRI examination as a screening test for prostate cancer.
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17
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Mashhadikhan M, Lamouki R, Moslemi E, Izadi A. Considering blood samples for early diagnosis of prostate cancer by evaluating prostate cancer antigen 3 expression values. JOURNAL OF CANCER RESEARCH AND PRACTICE 2020. [DOI: 10.4103/jcrp.jcrp_25_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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18
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Abdel-Rahman O. Prostate Cancer Incidence and Mortality in Relationship to Family History of Prostate Cancer; Findings From The PLCO Trial. Clin Genitourin Cancer 2019; 17:e837-e844. [PMID: 31213414 DOI: 10.1016/j.clgc.2019.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/16/2019] [Accepted: 05/21/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND The purpose of the study was to determine the relationship between family history of prostate cancer in a first-degree relative (FDR) and prostate cancer incidence and mortality. PATIENTS AND METHODS Deidentified data sets of men recruited in the Prostate, Lung, Colorectal, and Ovary (PLCO) trial were accessed. Men with complete information about family history of prostate cancer in an FDR were included. The effect of family history on prostate cancer incidence and mortality was assessed in a multivariate Cox regression model. Likewise, the effect of the number of FDRs with prostate cancer and the effect of youngest diagnosis age of an FDR with prostate cancer were assessed. RESULTS A total of 74,781 participants were included in the current analysis, including 5281 participants with family history of prostate cancer in an FDR and 69,500 participants without family history of prostate cancer in an FDR. Among participants without family history of prostate cancer in an FDR, a total of 7450 patients (10.5%) were subsequently diagnosed with prostate cancer; whereas among patients with family history of prostate cancer in an FDR, a total of 889 patients (16.5%) were subsequently diagnosed with prostate cancer. In an adjusted multivariate Cox regression model, family history of prostate cancer was associated with a higher probability of prostate cancer diagnosis (hazard ratio [HR], 1.590; 95% confidence interval [CI], 1.482-1.705; P < .001). The number of FDRs with prostate cancer proportionally correlated with higher prostate cancer incidence (HR, 1.529; 95% confidence interval [CI], 1.439-1.624; P < .001). Family history of prostate cancer in an FDR was not predictive of higher prostate cancer mortality in the PLCO screening (intervention) arm (HR, 0.829; 95% CI, 0.422-1.629; P = .587) whereas it was predictive of a higher prostate cancer mortality in the PLCO nonscreening (control) arm (HR, 1.894; 95% CI, 1.154-3.109; P = .012). Number of FDRs with prostate cancer was not associated with higher prostate cancer mortality in the PLCO screening (intervention) arm (HR, 0.956; 95% CI, 0.541-1.691; P = .878), whereas it was associated with higher prostate cancer mortality in the PLCO nonscreening (control) arm (HR, 1.643; 95% CI, 1.083-2.493; P = .020). CONCLUSION Family history of prostate cancer is associated with an increased risk of prostate cancer diagnosis in the overall cohort of patients as well as a higher risk of prostate cancer mortality in the nonscreened subcohort. Further prospective assessment of the role of screening among selected high-risk populations (including those with strong family history) is warranted.
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Affiliation(s)
- Omar Abdel-Rahman
- Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
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19
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Morrison BF, Gordon Y. Does a family history of prostate cancer affect screening behavior in Jamaican men? Rev Panam Salud Publica 2019; 42:e143. [PMID: 31093171 PMCID: PMC6385629 DOI: 10.26633/rpsp.2018.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 06/09/2018] [Indexed: 11/24/2022] Open
Abstract
Objective To determine 1) the characteristics of males with a family history of prostate cancer who presented for screening and 2) the association between family history and diagnosis of prostate cancer in a cohort of screened Jamaican men. Methods The study consisted of a prospective cohort of black men who screened at the Jamaica Cancer Society in Kingston between 2006 and 2016. Data were collected on: 1) age at screening and age at diagnosis of prostate cancer, 2) family history of prostate cancer, and 3) prostate-specific antigen (PSA) and digital rectal examination (DRE) findings. Results Approximately 600 (21.4%) of screened men who reported data on family history (2 791 / 2 867) said they had a family history of prostate cancer. Men with a family history of prostate cancer 1) commenced screening at a younger age than men without a family history (P <0.001) and 2) tended to have a younger age at diagnosis of prostate cancer (P = 0.262). There was no significantly increased risk of prostate cancer in men with a reported family history of prostate cancer (odds ratio: 1.4; 95% confidence interval: 0.821–2.386; P = 0.217). Conclusions Men with a family history of prostate cancer presented frequently for screening and earlier than those without. There was a lack of association between family history of prostate cancer and diagnosis. Further studies are needed to investigate this association and validate family histories.
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Affiliation(s)
- Belinda F Morrison
- Department of Surgery, University of the West Indies-Mona, Kingston, Jamaica
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20
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Amor S, Châlons P, Aires V, Delmas D. Polyphenol Extracts from Red Wine and Grapevine: Potential Effects on Cancers. Diseases 2018; 6:diseases6040106. [PMID: 30453669 PMCID: PMC6313659 DOI: 10.3390/diseases6040106] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/13/2018] [Accepted: 11/16/2018] [Indexed: 12/24/2022] Open
Abstract
Wine has been popular worldwide for many centuries and currently remains an important component of our diet. Scientific interest in wine and its health effects has grown considerably since the 1990s with the emergence of the “French Paradox” concept, correlating moderate wine consumption, a characteristic of the Mediterranean diet, and low incidence of coronary heart diseases. Since then, the positive effects on health, health promotion, disease prevention, and disease prognosis of moderate wine consumption, in particular red wine, have been attributed to its polyphenolic compounds such as resveratrol, quercetin, and other flavonoids acting as antioxidants. Several epidemiological, in vivo and in vitro, studies have reported that moderate red wine or red wine polyphenolic extract consumption may be active in the prevention and treatment of chronic diseases such as cardiovascular disease, metabolic syndrome, degenerative pathologies, and cancer. The aim of this review is to summarize the current findings about the effects of red wine polyphenols on cancer and to discuss how the polyphenolic composition of red wine may influence its chemopreventive properties.
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Affiliation(s)
- Souheila Amor
- Université de Bourgogne-Franche Comté, Dijon F-21000, France.
- Centre de Recherche INSERM U1231-Cancer and Adaptative Immune Response Team⁻Bioactive Molecules and Health research group, Dijon F-21000, France.
| | - Pauline Châlons
- Université de Bourgogne-Franche Comté, Dijon F-21000, France.
- Centre de Recherche INSERM U1231-Cancer and Adaptative Immune Response Team⁻Bioactive Molecules and Health research group, Dijon F-21000, France.
| | - Virginie Aires
- Université de Bourgogne-Franche Comté, Dijon F-21000, France.
- Centre de Recherche INSERM U1231-Cancer and Adaptative Immune Response Team⁻Bioactive Molecules and Health research group, Dijon F-21000, France.
| | - Dominique Delmas
- Université de Bourgogne-Franche Comté, Dijon F-21000, France.
- Centre de Recherche INSERM U1231-Cancer and Adaptative Immune Response Team⁻Bioactive Molecules and Health research group, Dijon F-21000, France.
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21
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Amor S, Châlons P, Aires V, Delmas D. Polyphenol Extracts from Red Wine and Grapevine: Potential Effects on Cancers. DISEASES (BASEL, SWITZERLAND) 2018. [PMID: 30453669 DOI: 10.3390/diseases6040106]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Wine has been popular worldwide for many centuries and currently remains an important component of our diet. Scientific interest in wine and its health effects has grown considerably since the 1990s with the emergence of the "French Paradox" concept, correlating moderate wine consumption, a characteristic of the Mediterranean diet, and low incidence of coronary heart diseases. Since then, the positive effects on health, health promotion, disease prevention, and disease prognosis of moderate wine consumption, in particular red wine, have been attributed to its polyphenolic compounds such as resveratrol, quercetin, and other flavonoids acting as antioxidants. Several epidemiological, in vivo and in vitro, studies have reported that moderate red wine or red wine polyphenolic extract consumption may be active in the prevention and treatment of chronic diseases such as cardiovascular disease, metabolic syndrome, degenerative pathologies, and cancer. The aim of this review is to summarize the current findings about the effects of red wine polyphenols on cancer and to discuss how the polyphenolic composition of red wine may influence its chemopreventive properties.
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Affiliation(s)
- Souheila Amor
- Université de Bourgogne-Franche Comté, Dijon F-21000, France.
- Centre de Recherche INSERM U1231-Cancer and Adaptative Immune Response Team⁻Bioactive Molecules and Health research group, Dijon F-21000, France.
| | - Pauline Châlons
- Université de Bourgogne-Franche Comté, Dijon F-21000, France.
- Centre de Recherche INSERM U1231-Cancer and Adaptative Immune Response Team⁻Bioactive Molecules and Health research group, Dijon F-21000, France.
| | - Virginie Aires
- Université de Bourgogne-Franche Comté, Dijon F-21000, France.
- Centre de Recherche INSERM U1231-Cancer and Adaptative Immune Response Team⁻Bioactive Molecules and Health research group, Dijon F-21000, France.
| | - Dominique Delmas
- Université de Bourgogne-Franche Comté, Dijon F-21000, France.
- Centre de Recherche INSERM U1231-Cancer and Adaptative Immune Response Team⁻Bioactive Molecules and Health research group, Dijon F-21000, France.
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22
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Tikkinen KAO, Dahm P, Lytvyn L, Heen AF, Vernooij RWM, Siemieniuk RAC, Wheeler R, Vaughan B, Fobuzi AC, Blanker MH, Junod N, Sommer J, Stirnemann J, Yoshimura M, Auer R, MacDonald H, Guyatt G, Vandvik PO, Agoritsas T. Prostate cancer screening with prostate-specific antigen (PSA) test: a clinical practice guideline. BMJ 2018; 362:k3581. [PMID: 30185545 PMCID: PMC6283372 DOI: 10.1136/bmj.k3581] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Kari A O Tikkinen
- Department of Urology, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland
- Department of Public Health, University of Helsinki, 00014 Helsinki, Finland
| | - Philipp Dahm
- Urology Section, Minneapolis VAMC and Department of Urology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lyubov Lytvyn
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Anja F Heen
- Department of Medicine, Innlandet Hospital Trust-division, Gjøvik, Norway
| | - Robin W M Vernooij
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Reed A C Siemieniuk
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | - Bill Vaughan
- Citizens United for Evidence-Based Medicine, Virginia, USA
| | - Awah Cletus Fobuzi
- Cameroon Consumer Service Organization (CamCoSO), Bamenda, Cameroon
- Coalition of Civil Society Organizations Cameroon, Bamenda, Cameroon
| | - Marco H Blanker
- Department of General Practice and Elderly Medicine, University Medical Centre-Groningen, University of Groningen, Groningen, The Netherlands
| | - Noelle Junod
- Institute of Primary Care, Geneva University Hospitals, Geneva, Switzerland
| | - Johanna Sommer
- Unit of Primary Care Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jérôme Stirnemann
- Division General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Reto Auer
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
| | | | - Gordon Guyatt
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Per Olav Vandvik
- Department of Medicine, Innlandet Hospital Trust-division, Gjøvik, Norway
| | - Thomas Agoritsas
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Division General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland
- Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland
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23
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Vartolomei MD, Kimura S, Ferro M, Foerster B, Abufaraj M, Briganti A, Karakiewicz PI, Shariat SF. The impact of moderate wine consumption on the risk of developing prostate cancer. Clin Epidemiol 2018; 10:431-444. [PMID: 29713200 PMCID: PMC5909789 DOI: 10.2147/clep.s163668] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Objective To investigate the impact of moderate wine consumption on the risk of prostate cancer (PCa). We focused on the differential effect of moderate consumption of red versus white wine. Design This study was a meta-analysis that includes data from case–control and cohort studies. Materials and methods A systematic search of Web of Science, Medline/PubMed, and Cochrane library was performed on December 1, 2017. Studies were deemed eligible if they assessed the risk of PCa due to red, white, or any wine using multivariable logistic regression analysis. We performed a formal meta-analysis for the risk of PCa according to moderate wine and wine type consumption (white or red). Heterogeneity between studies was assessed using Cochrane’s Q test and I2 statistics. Publication bias was assessed using Egger’s regression test. Results A total of 930 abstracts and titles were initially identified. After removal of duplicates, reviews, and conference abstracts, 83 full-text original articles were screened. Seventeen studies (611,169 subjects) were included for final evaluation and fulfilled the inclusion criteria. In the case of moderate wine consumption: the pooled risk ratio (RR) for the risk of PCa was 0.98 (95% CI 0.92–1.05, p=0.57) in the multivariable analysis. Moderate white wine consumption increased the risk of PCa with a pooled RR of 1.26 (95% CI 1.10–1.43, p=0.001) in the multi-variable analysis. Meanwhile, moderate red wine consumption had a protective role reducing the risk by 12% (RR 0.88, 95% CI 0.78–0.999, p=0.047) in the multivariable analysis that comprised 222,447 subjects. Conclusions In this meta-analysis, moderate wine consumption did not impact the risk of PCa. Interestingly, regarding the type of wine, moderate consumption of white wine increased the risk of PCa, whereas moderate consumption of red wine had a protective effect. Further analyses are needed to assess the differential molecular effect of white and red wine conferring their impact on PCa risk.
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Affiliation(s)
- Mihai Dorin Vartolomei
- Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Tirgu Mures, Romania.,Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Shoji Kimura
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Matteo Ferro
- Division of Urology, European Institute of Oncology, Milan, Italy
| | - Beat Foerster
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Mohammad Abufaraj
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Alberto Briganti
- Department of Urology, Vita Salute San Raffaele University, Milan, Italy
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.,Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Urology, Weill Cornell Medical College, New York, NY, USA
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24
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Abstract
In this article, the principle of randomised trials are first described and then prostate cancer screening trials published to date are evaluated based on these principles. A summary of the randomised prostate cancer screening is provided. The conclusion that can be made from the results of the screening trials, as well as limitations of the evidence and open questions are outlined in the end.
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Affiliation(s)
- Anssi Auvinen
- Faculty of Social Sciences/Health Sciences, University of Tampere, Tampere, Finland
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25
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Kohestani K, Chilov M, Carlsson SV. Prostate cancer screening-when to start and how to screen? Transl Androl Urol 2018; 7:34-45. [PMID: 29594018 PMCID: PMC5861291 DOI: 10.21037/tau.2017.12.25] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Prostate-specific antigen (PSA) screening reduces prostate cancer (PCa) mortality; however such screening may lead to harm in terms of overdiagnosis and overtreatment. Therefore, upfront shared decision making involving a discussion about pros and cons between a physician and a patient is crucial. Total PSA remains the most commonly used screening tool and is a strong predictor of future life-threatening PCa. Currently there is no strong consensus on the age at which to start PSA screening. Most guidelines recommend PSA screening to start no later than at age 55 and involve well-informed men in good health and a life expectancy of at least 10–15 years. Some suggest to start screening in early midlife for men with familial predisposition and men of African-American descent. Others suggest starting conversations at age 45 for all men. Re-screening intervals can be risk-stratified as guided by the man’s age, general health and PSA-value; longer intervals for those at lower risk and shorter intervals for those at higher risk. Overdiagnosis and unnecessary biopsies can be reduced using reflex tests. Magnetic resonance imaging in the pre-diagnostic setting holds promise in pilot studies and large-scale prospective studies are ongoing.
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Affiliation(s)
- Kimia Kohestani
- Institute of Clinical Sciences, Department of Urology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marina Chilov
- Medical Library, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Sigrid V Carlsson
- Institute of Clinical Sciences, Department of Urology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
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26
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Lee KS, Koo KC, Chung BH. The impact of a family history of prostate cancer on the prognosis and features of the disease in Korea: results from a cross-sectional longitudinal pilot study. Int Urol Nephrol 2017; 49:2119-2125. [PMID: 28905176 DOI: 10.1007/s11255-017-1696-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 09/01/2017] [Indexed: 01/17/2023]
Abstract
PURPOSE Reports on the impact of a family history of prostate cancer among Asians are scarce. We evaluated whether a positive prostate cancer family history is associated with the prognosis and features of the disease. METHODS From January 2006 to December 2015, patients who received treatment for pathologically diagnosed prostate cancer were enrolled. Information on family history was obtained via self-administered questionnaires between January 2015 and December 2016. The overall survival rate for all patients and the rate of biochemical failure after radical prostatectomy were assessed according to the presence of family history. RESULTS Of 1266 patients (median age, 68.1 years; median prostate-specific antigen, 8.73 ng/mL; median follow-up, 40.0 months), 47 (3.8%) were identified as having a family history. Men with a family history had a younger age, higher proportion of cases diagnosed before 55 years of age, and lower stage than those without a family history. Family history was not a potential risk factor for overall survival. In an analysis of patients who underwent radical prostatectomy (median prostate-specific antigen, 7.40 ng/mL; median follow-up, 40.5 months), no differences in pathologic characteristics were found between patients with (n = 39, 93.5%) and without (n = 567, 6.4%) a family history. Family history was not predictive of biochemical failure. CONCLUSIONS A family history of prostate cancer seemed to have no effect on prognosis and disease aggressiveness. However, this study proposed a rationale for performing earlier prostate-specific antigen testing in men with a family history of prostate cancer.
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Affiliation(s)
- Kwang Suk Lee
- Department of Urology, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, Korea
| | - Kyo Chul Koo
- Department of Urology, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, Korea
| | - Byung Ha Chung
- Department of Urology, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, Korea.
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27
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Barry MJ, Simmons LH. Prevention of Prostate Cancer Morbidity and Mortality: Primary Prevention and Early Detection. Med Clin North Am 2017; 101:787-806. [PMID: 28577627 DOI: 10.1016/j.mcna.2017.03.009] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
More than any other cancer, prostate cancer screening with the prostate-specific antigen (PSA) tests increases the risk a man will have to face a diagnosis of prostate cancer. The best evidence from screening trials suggests a small but finite benefit from prostate cancer screening in terms of prostate cancer-specific mortality, about 1 fewer prostate cancer death per 1000 men screened over 10 years. The more serious harms of prostate cancer screening, such as erectile dysfunction and incontinence, result from cancer treatment with surgery or radiation, particularly for men whose PSA-detected cancers were never destined to cause morbidity or mortality.
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Affiliation(s)
- Michael J Barry
- General Medicine Division, Massachusetts General Hospital, 50 Staniford Street, Suite 957, Boston, MA 02114, USA.
| | - Leigh H Simmons
- General Medicine Division, Massachusetts General Hospital, 50 Staniford Street, Suite 957, Boston, MA 02114, USA
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28
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Telang JM, Lane BR, Cher ML, Miller DC, Dupree JM. Prostate cancer family history and eligibility for active surveillance: a systematic review of the literature. BJU Int 2017; 120:464-467. [DOI: 10.1111/bju.13862] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jaya M. Telang
- Department of Urology; University of Michigan; Ann Arbor MI USA
| | | | - Michael L. Cher
- Department of Urology; Wayne State University; Detroit MI USA
| | - David C. Miller
- Department of Urology; University of Michigan; Ann Arbor MI USA
| | - James M. Dupree
- Department of Urology; University of Michigan; Ann Arbor MI USA
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29
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Ali A, Hoyle A, Baena E, Clarke NW. Identification and evaluation of clinically significant prostate cancer: a step towards personalized diagnosis. Curr Opin Urol 2017; 27:217-224. [PMID: 28212121 DOI: 10.1097/mou.0000000000000385] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Prostate cancer (PCa) diagnostics are evolving rapidly. The quest to differentiate 'clinically significant' from 'clinically insignificant' disease has gathered momentum, leading to substantial change in traditional diagnostic approaches. Herein, we review the relevant information on currently available biomarkers and assess their ability to help physicians and patients in making a shared and personalized decision based on their individual risk of harbouring clinically significant disease. RECENT FINDINGS Serum, urine, tissue and imaging biomarkers have been evaluated to improve the identification of clinically significant disease, and this international effort has yielded promising, but not always consistent results. Changes in MRI technology have realized a quantum change, and this facility is now becoming more widely incorporated into diagnostic and disease risk-stratification protocols. However, standardization and further validation is required. SUMMARY Acceptance and widespread adoption of serum, urine and genetic markers is awaited, but novel and promising techniques alone and in combination have emerged. With validation and further focus, these may be adopted more widely.
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Affiliation(s)
- Adnan Ali
- aProstate Oncobiology bCancer Research UK Manchester Institute cBelfast-Manchester Movember Centre of Excellence, Cancer Research UK Manchester Institute, University of Manchester dDepartment of Surgery, The Christie NHS Foundation Trust, Manchester eDepartment of Urology, Salford NHS Foundation Trust, Salford, UK
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Stewart RW, Lizama S, Peairs K, Sateia HF, Choi Y. Screening for prostate cancer. Semin Oncol 2017; 44:47-56. [DOI: 10.1053/j.seminoncol.2017.02.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 02/06/2017] [Indexed: 02/07/2023]
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Selkirk CG, Helfand BT. To PSA or not to PSA? Still a question for men with a family history of prostate cancer. BJU Int 2016; 117:545. [PMID: 26969030 DOI: 10.1111/bju.13372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Christina G Selkirk
- Center for Medical Genetics, Department of Medicine, NorthShore University HealthSystem, Chicago, IL, USA
| | - Brian T Helfand
- John and Carol Walter Center for Urological Health, Department of Surgery, NorthShore University HealthSystem, Chicago, IL, USA
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