OBJECTIVE: To determine whether there are differences in prostate specific antigen (PSA) at diagnosis or changes in PSA between US and European populations of men with and without prostate cancer.
SUBJECTS AND METHODS: Repeated measures of PSA from six clinically and geographically diverse patient cohorts: two cohorts of men with PSA-detected prostate cancer, two cohorts with clinically-detected prostate cancer and two cohorts of men without prostate cancer. Using multilevel models, average PSA at diagnosis and PSA change over time were compared between populations.
RESULTS: Annual percentage PSA change of 4-5% was similar between men without cancer and men with PSA-detected cancer. PSA at diagnosis was 1.7ng/ml lower in a US cohort of PSA-detected men (95% CI 1.3-2.0ng/ml), compared to a PSA-detected UK cohort, but there was no evidence for a different rate of PSA change between these populations.
CONCLUSION: PSA changes over time are similar in UK and US men diagnosed through PSA testing and even in men without prostate cancer. Further development of PSA models to monitor men on active surveillance should be undertaken in order to take advantage of these similarities. We found no evidence that guidelines for using PSA to monitor men cannot be passed between US and European studies. This article is protected by copyright. All rights reserved.
- BTC (Bristol Trials Centre)
- Centre for Surgical Research
- active surveillance
- prostate speciﬁc antigen
- prostate cancer