EAU Session On Prostate Cancer Screening

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Men's health
Article Date: 02 Apr 2007 - 0:00 PDT

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UroToday.com - A poster session on "Prostate Cancer Screening" took place at the EAU on Thursday March 22, 2007. Two posters from this session are covered herein.

Dr. Schroeder, Rotterdam presented a poster "How to Screen for Prostate Cancer (PC) in Men presenting with Low PSA (<3.0ng/ml) " Do We Have to Find All Cancers?" The study sought to study the characteristics of men detected with PC in the low PSA range. In the Rotterdam screening project, 15,852 men were screened and 79% presented with a PSA <3.0ng/ml at the first screen. The PC found in men by screening after 4 and 8 years and intervening intervals was characterized. Interval PC was diagnosed in 14 men during year 0-4, 2 were >stage T2 and thus potentially incurable. During the 2nd screen, at 4 years, 1,090 showed PSA progression to >3.0ng/ml and were biopsied. PC was detected in 275 (25%) and 7 were potentially incurable (including 2 metastatic cases). Dr. Schroeder concludes that it is acceptable to delay the need to diagnose PC in the PSA range <3.0ng/ml as >95% of cases detected as interval PC or after PSA progression are still potentially confined and curable.

Dr. Pelzer, Innsbruck presented data that the pathologic characteristics of PC detected in screened patients is favorable compared to PC detected in non-screened men. Of 997 RPs performed 1999-2006, 806 men were treated for screen detected PC and 191 were referred for surgery and not screen detected. Patient age and PSA levels were similar between the groups. The screen detected patients had statistically lower pathologic stages at surgery and lower Gleason scores. The rate of positive surgical margins was 11.7% in the screened group and 24.4% in the non-screened group. The worse pathologic variables suggest that the non-screened group is at higher risk for disease relapse compared to the screened patients.

Reviewed by UroToday.com Contributing Editor By Christopher P. Evans, M.D., FACS

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