DOI QR코드

DOI QR Code

Cumulative Probability of Prostate Cancer Detection Using the International Prostate Symptom Score in a Prostate-specific Antigen-based Population Screening Program in Japan

  • Kitagawa, Yasuhide (Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University) ;
  • Urata, Satoko (Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University) ;
  • Narimoto, Kazutaka (Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University) ;
  • Nakagawa, Tomomi (Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University) ;
  • Izumi, Kouji (Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University) ;
  • Kadono, Yoshifumi (Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University) ;
  • Konaka, Hiroyuki (Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University) ;
  • Mizokami, Atsushi (Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University) ;
  • Namiki, Mikio (Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University)
  • Published : 2014.09.15

Abstract

The International Prostate Symptom Score (IPSS) is often used as an interview sheet for assessing lower urinary tract symptoms (LUTS) at the time of prostate-specific antigen (PSA) testing during population-based screening for prostate cancer. However, the relationship between prostate cancer detection and LUTS status remains controversial. To elucidate this relationship, the cumulative probability of prostate cancer detection using IPSS in biopsy samples from patients categorized by serum PSA levels was investigated. The clinical characteristics of prostate cancer detected using IPSS during screening were also investigated. A total of 1,739 men aged 54-75 years with elevated serum PSA levels who completed the IPSS questionnaire during the initial population screening in Kanazawa City, Japan and underwent systematic transrectal ultrasonography-guided prostate biopsy between 2000 and 2013 were enrolled in the present study. Of the 1,739 men, 544 (31.3%) were diagnosed with prostate cancer during the observation period. The probability of cancer detection at 3 years in the entire study population was 27.4% and 32.7% for men with $IPSS{\leq}7$ and those with $IPSS{\geq}8$, respectively; there was no statistically significant difference between groups. In men with serum PSA levels of 6.1 to 12.0ng/mL at initial screening, the probability of cancer detection was significantly higher in men with $IPSS{\leq}7$ than in those with $IPSS{\geq}8$. There were no significant differences in clinical characteristics between groups of patients stratified by IPSS. These findings indicate that the use of IPSS for LUTS status evaluation may be useful for prostate cancer detection in the limited range of serum PSA levels.

Keywords

References

  1. Bouchardy C, Fioretta G, Rapiti E, et al (2008). Recent trends in prostate cancer mortality show a continuous decrease in several countries. Int J Cancer, 123, 421-9. https://doi.org/10.1002/ijc.23520
  2. Brown CT, O'Flynn E, van der Meulen J, et al (2003). The fear of prostate cancer in men with lower urinary tract symptoms: should symptomatic men be screened? BJU Int, 91, 30-2. https://doi.org/10.1046/j.1464-410X.2003.04013.x
  3. Franlund M, Carlsson S, Stranne J, Aus G, Hugosson J (2012). The absence of voiding symptoms in men with a prostatespecific antigen (PSA) concentration of ${\geq}$3.0ng/mL is an independent risk factor for prostate cancer: results from the Gothenburg randomized screening trial. BJU Int, 110, 638-43. https://doi.org/10.1111/j.1464-410X.2012.10962.x
  4. Gretzer MB, Partin AW (2003). PSA markers in prostate cancer detection. Urol Clin North Am, 30, 677-86. https://doi.org/10.1016/S0094-0143(03)00057-0
  5. Hochberg DA, Armenakas NA, Fracchia JA (2000). Relationship of prostate-specific antigen and prostate volume in patients with biopsy proven benign prostatic hyperplasia. Prostate, 45, 315-9. https://doi.org/10.1002/1097-0045(20001201)45:4<315::AID-PROS5>3.0.CO;2-2
  6. International Union Against Cancer (1997). Urologic Tumors: Prostate. In 'TNM Classification of Malignant Tumours. 5th ed.' Eds Sobin LH and Wittekind CH. John Wiley & Sons, New York pp170-3
  7. Ito K (2009). Prostate-specific antigen-based screening for prostate cancer: evidence, controversies and future perspectives. Int J Urol, 16, 458-64. https://doi.org/10.1111/j.1442-2042.2009.02293.x
  8. Ito M, Masuda H, Kawakami S, et al (2013). Impact of lower urinary tract symptoms on prostate cancer risk among Japanese men with prostate-specific antigen <10ng/ml and non-suspicious digital rectal examination. Int J Urol, 20, 1163-8. https://doi.org/10.1111/iju.12141
  9. Kash DP, Lal M, Hashmi H, Mubarak M (2014). Utility of digital rectal examination, serum prostate specific antigen, and transrectal ultrasound in the detection of prostate cancer: a developing country perspective. Asian Pac J Cancer Prev, 15, 3087-91. https://doi.org/10.7314/APJCP.2014.15.7.3087
  10. Kitagawa Y, Mizokami A, Nakashima K, et al (2011). Clinical outcomes of prostate cancer patients detected by prostatespecific antigen-based population screening in Kanazawa city, Japan. Int J Urol, 18, 592-6. https://doi.org/10.1111/j.1442-2042.2011.02796.x
  11. Kitagawa Y, Mizokami A, Namiki M (2013). Trends of clinical symptoms and prognosis of middle-aged prostate cancer patients after instigation of prostate specific antigen-based population screening. Prostate Int, 1, 65-8. https://doi.org/10.12954/PI.12017
  12. Kobori Y, Kitagawa Y, Mizokami A, et al (2008). Free-to-total prostate-specific antigen (PSA) ratio contributes to an increased rate of prostate cancer detection in a Japanese population screened using a PSA level of 2.1-10.0ng/ml as a criterion. Int J Clin Oncol, 13, 229-32. https://doi.org/10.1007/s10147-007-0742-2
  13. Kubota Y, Ito K, Imai K, et al (2002). Effectiveness of mass screening for the prognosis of prostate cancer patients in Japanese communities. Prostate, 50, 262-9. https://doi.org/10.1002/pros.10057
  14. Kwon HT, Ma GX, Gold RS, Atkinson NL, Wang MQ (2013). Primary care physician's cancer screening recommendation practices and perceptions of cancer risk of Asian Americans. Asian Pac J Cancer Prev, 14, 1999-2004. https://doi.org/10.7314/APJCP.2013.14.3.1999
  15. Matsubara A, Yasumoto H, Teishima J, et al (2006). Lower urinary tract symptoms and risk of prostate cancer in Japanese men. Int J Urol, 13, 1098-102. https://doi.org/10.1111/j.1442-2042.2006.01504.x
  16. Mochtar CA, Kiemeney LA, van Riemsdijk MM, et al (2003). Prostate-specific antigen as estimator of prostate volume in the management of patients with symptomatic benign prostatic hyperplasia. Eur Urol, 44, 695-700. https://doi.org/10.1016/S0302-2838(03)00384-1
  17. Okihara K, Kitamura K, Okada K, et al (2008). Ten year trend in prostate cancer screening with high prostate-specific antigen exposure rate in Japan. Int J Urol, 15, 156-61. https://doi.org/10.1111/j.1442-2042.2007.01957.x
  18. Schulman CC, Kirby R, Fitzpatrick JM (2003). Awareness of prostate cancer among the general public: findings of an independent international survey. Eur Urol, 44, 294-302. https://doi.org/10.1016/S0302-2838(03)00200-8
  19. Shin S, Kim YH, Hwang JS, et al (2014). Economic evaluation of prostate cancer screening test as a national cancer screening program in South Korea. Asian Pac J Cancer Prev, 15, 3383-9. https://doi.org/10.7314/APJCP.2014.15.8.3383
  20. Verim L, Yildirim A, Basok EK, et al (2013). Impact of PSA and DRE on histologic findings at prostate biopsy in Turkish men over 75 years of age. Asian Pac J Cancer Prev, 14, 6085-8. https://doi.org/10.7314/APJCP.2013.14.10.6085
  21. Young JM, Muscatello DJ, Ward JE (2000). Are men with lower urinary tract symptoms at increased risk of prostate cancer? A systematic review and critique of the available evidence. BJU Int, 85, 1037-48. https://doi.org/10.1046/j.1464-410x.2000.00659.x
  22. Zheng XY, Zhang P, Xie LP, et al (2012). Prostate-specific antigen velocity (PSAV) and PSAV per initial volume (PSADV) for early detection of prostate cancer in Chinese men. Asian Pac J Cancer Prev, 13, 5529-33. https://doi.org/10.7314/APJCP.2012.13.11.5529