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Objectives: We investigated a clinical features and outcomes of prostate cancer detected in Tone Central Hospital., Materials and Methods: We investigated clinical features of 532 patients with pathologically confirmed prostate cancer detected in our hospital between 1987 and 2006. Furthermore, we compared survival rates of screen detected prostate cancer (SC group) with those of non-screen detected prostate cancer (NSC group) for 362 cases diagnosed with prostate cancer after 1999. 362 cases consist of 223 patients in SC group and 139 patients in NSC group., Results: Since 1987, the annual number of newly diagnosed patients has gradually increased and we recognized stage migration, a tendency toward an annual decrease in the incidence of stages A and D and an increase in that of stage B. The stage distributions of SC group (223 cases) and NSC group (139 cases), respectively, were 0.4% (1/223) and 9.4% (13/139) in stage A (p = 0.0011), 71.3% (159/223) and 31.7% (44/139) in stage B (p < 0.0001), 24.2% (54/223) and 23.7% (33/139) in stage C (p = 0.9182), and 4.0% (9/223) and 34.6% (46/223) in stage D (p < 0.0001). The 3, 5 and 7-year overall survival rates, respectively, were 95.6%, 92.7% and 84.1% in SC group, and 83.2%, 74.3% and 60.8% in NSC group (p < 0.0001). Furthermore, the 3, 5 and 7-year cause-specific survival rates, respectively, were 98.8%, 97.3% and 95.9% in SC group, and 90.2%, 87.7% and 79.4% in NSC group (p < 0.0001)., Conclusions: Clinical stage distribution has been changed between 1987 and 2006. Furthermore, overall and cause specific survival rates were better in screen detected prostate cancer than non-screen detected prostate cancer, because of increases in earlier stage of prostate cancer in SC group.

Objectives: According to epidemiologic surveys, the number of deaths from prostate cancer in Japanese men increased rapidly from 1970 to 2006. However, it is difficult to know the real incidence of, and mortality due to, prostate cancer because the reliability of death certificates and the cancer registry system in Japan are poor. Recently, several studies have demonstrated that baseline prostate-specific antigen (PSA) levels could be one of the most important predictive factors for developing prostate cancer. Therefore, we hypothesized that changes in the baseline PSA distribution in the screening population could reflect trends in the true incidence rate of prostate cancer., Methods: From 1988 to 2003, 32,274 men, aged 50-79 years, participated in population-based screening for prostate cancer for the first time in Gunma Prefecture, Japan. Changes in the baseline PSA distributions, stratified by a 5-year age range and calendar year, were investigated. The relationships between age and log(10) PSA levels were also investigated and stratified by calendar year., Results: The median baseline PSA level was 0.9-1.2 ng/mL and had not recently increased. No specific trends were found in the percentages of participants with a PSA level greater than 2.0, 4.0, or 10.0 ng/mL within the same age range during the 16-year period., Conclusions: The increase in the incidence of, and mortality rates for, prostate cancer demonstrated by epidemiologic research might have been misleading in Japan. Investigational changes in the baseline prostate-specific antigen (PSA) distribution of the screened populations revealed that the true incidence rate of prostate cancer in Japan might have been almost the same during the past 16 years.

Background: The cut-off value of prostate-specific antigen velocity (PSAV) was investigated in relation to the initial prostate-specific antigen (PSA) value in subjects with initial values of 1.0-4.0 ng/mL, and the usefulness and limitations of PSAV as a screening test for prostate cancer were examined., Methods: In this study, 4883 men who underwent mass screening for prostate cancer two or more times between 1987 and 1998 and had initial PSA levels of 1.0-4.0 ng/mL were investigated. The subjects ranged in age from 42 to 96 years (mean: 68.0 +/- 6.6 years). The cut-off value of PSAV was set at 0.1-1.5 ng/mL per year, and the sensitivity, specificity, efficiency and positive predictive value (PPV) of PSAV for detecting prostate cancer were determined according to the initial PSA value. A similar examination of the average PSAV was carried out in 2888 subjects with three or more visits for mass screening for prostate cancer., Results: The diagnostic efficiency of PSAV was optimal with cut-off values of 0.3 and 0.75 ng/mL per year in those subjects with initial PSA levels of 1.0-1.9 and 2.0-4.0 ng/mL, respectively, but the PPV was low at 1.8% in subjects with initial PSA levels of 1.0-1.9 ng/mL. When the cutoff value of PSAV was set at 1.2 ng/mL per year in individuals with initial PSA levels of 1.0-1.9 ng/mL, the PPV increased to 7.3% and the sensitivity was 40%. The diagnostic efficiency of the average PSAV was optimal at the cut-off values of 0.2 and 0.4 ng/mL per year in subjects with initial PSA levels of 1.0-1.9 and 2.0-4.0 ng/mL, respectively, but the PPV was low at 2.2% in the subjects with initial PSA values of 1.0-1.9 ng/mL. When the cut-off value of PSAV was set at 0.75 ng/mL per year in individuals with initial PSA levels of 1.0-1.9 ng/mL, the PPV was 9.8% and the sensitivity was 46%., Conclusion: It is possible to improve the diagnostic accuracy of prostate cancer screening using the cut-off value of PSAV and average PSAV in subjects with initial PSA levels of 1.0-4.0 ng/mL. The cut-off values of PSAV should be set at 1.2 and 0.75 ng/mL per year in individuals with initial PSA levels of 1.0-1.9 and 2.0-4.0 ng/mL, respectively. The cut-off values of the average PSAV should be set at 0.75 and 0.4 ng/mL per year in individuals with initial PSA levels of 1.0-1.9 and 2.0-4.0 ng/mL, respectively.

AbstractBackground: Few articles describe stage and pathology distribution of prostate cancer by age, yet understanding these topics may provide clues to the etiology of this disease. The present study describes the distribution of stage and pathology of prostate cancer in terms of age and considers effective detection of early stage cancer by mass screening (MS). Methods: Data presented in this study were based on patient’s files from MS and the Gunma Urological Oncology Study Group (GUOSG) registry from 1981 to 1996 in Gunma Prefecture, Japan. Results: Age did not significantly correlate with stage distribution among the GUOSG patients, whereas stage tended to advance with age among the MS patients. Stage B was detected more frequently than any other stage in all age groups of the MS patients, whereas stage C and stage D were detected at similar rates in all age groups. After prostate specific antigen (PSA) had been introduced in MS, the percentage of early stage cancer increased at an earlier age. Pathology distribution did not significantly differ in any group. Conclusions: The data obtained from MS cancer patients showed that tumor stage tends to advance with age. We believe that the younger age group should be examined by MS using PSA to effectively detect early prostate cancer. [ABSTRACT FROM AUTHOR]