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Prostate specific antigen and biopsy contamination in the Göteborg-1 randomized, population-based, prostate cancer screening trial
Department of Urology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Social Work, Faculty of Social Sciences, University of Gothenburg, Gothenburg, Sweden.
Sahlgrenska University Hospital, Department of Urology, Region Västra Götaland, Sweden; Regional Cancer Center West, Western Sweden Healthcare Region, Gothenburg, Sweden.
Umeå universitet, Medicinska fakulteten, Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM). Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi. Department of Urology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID-id: 0000-0002-2013-0887
Department of Urology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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2022 (Engelska)Ingår i: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 208, nr 5, s. 1018-1027Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

PURPOSE: Even when a screening study has demonstrated a mortality reduction, the degree of pre-testing and contamination is of importance as it can dilute the "true" effect of screening. Our object was to describe the level of pre-testing and contamination in the Göteborg-1 prostate cancer screening trial.

MATERIALS AND METHODS: A total of 20,000 men, 50-64 years old, were invited in 1994 and randomized to either a screening group (offered prostate specific antigen testing every 2 years) or to a control group. Follow-up was through December 31, 2014. Outcome measurement was overall testing in the screening group and control group. A positive prostate specific antigen test was defined as a prostate specific antigen ≥3 ng/ml.

RESULTS: In the study, 4.2% in the screening group and 4.6% men in the control group were tested before study start. During follow-up, 72% in the control group took at least 1 prostate specific antigen test (contamination) compared to 87% of men in the screening group. Of all prostate specific antigens, 24% in the screening group and 39% in the control group were above threshold. In total, 66% of the men underwent prostate biopsy within 12 months from a raised prostate specific antigen in the screening group and 28% in the control group.

CONCLUSIONS: Similar proportions of men were prostate specific antigen-tested in both the screening group and control group, yet only a minority of contamination prostate specific antigens led to biopsy. Also, men in the screening group started screening at a younger age. These could both be explanations for our result that organized screening is more effective in reducing prostate cancer mortality than non-organized testing. When carried out properly and compared to an unscreened population, the effects of organized screening are likely even greater than previously shown in the Göteborg screening trial.

Ort, förlag, år, upplaga, sidor
American urological association , 2022. Vol. 208, nr 5, s. 1018-1027
Nyckelord [en]
prostate-specific antigen, prostatic neoplasms
Nationell ämneskategori
Urologi och njurmedicin Cancer och onkologi
Identifikatorer
URN: urn:nbn:se:umu:diva-200379DOI: 10.1097/JU.0000000000002835ISI: 000947762500016PubMedID: 35771961Scopus ID: 2-s2.0-85139378177OAI: oai:DiVA.org:umu-200379DiVA, id: diva2:1709378
Forskningsfinansiär
Cancerfonden, 20 1360 PjFVetenskapsrådet, 2020-02477Knut och Alice Wallenbergs Stiftelse
Anmärkning

The article ends on page 1025, pages 1025-1027 include editorial comments.

Tillgänglig från: 2022-11-08 Skapad: 2022-11-08 Senast uppdaterad: 2023-09-05Bibliografiskt granskad

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Josefsson, Andreas

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Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM)Urologi och andrologi
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Journal of Urology
Urologi och njurmedicinCancer och onkologi

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