Historical prostate cancer screening and treatment outcomes from a single institution
Clinical Medicine & Research, 08/21/2012
Cross DS et al. – Individuals diagnosed and treated for prostate cancer within the Marshfield Clinic comprehensive care setting follow national trends with a decreased age of diagnosis since the advent of prostate specific antigen (PSA) screening. Outcomes for individuals treated within the Clinic system are also comparable to national trends.Methods
- Electronic chart ion from the cancer registry and the electronic medical record was conducted (N=6,181).
- Data ed included age at diagnosis; stage and grade of tumor; prostate specific antigen (PSA) values before, at, and after diagnosis; initial cancer treatment; follow–up time; subsequent cancer treatments; evidence of metastasis; age of death; and cause of death, if known.
- The average age of prostate cancer diagnosis has decreased from 70–71 years in the 1960’s and 1970’s to an average age at diagnosis of 67 years in the 2000’s (P<0.001).
- This decrease in age occurred within the decades of implementation of PSA screening.
- Approximately 74% of men diagnosed with prostate cancer within the PSA screening era had at least one PSA test, and the presence of a PSA test did not appear to change treatment outcome.
- Age, grade, and stage were the biggest predictors of prostate cancer outcome.
- There was no difference in event–free survival between current treatment types (radical prostatectomy, brachytherapy, photon treatment, or intensity–modulated radiation therapy) (2003 or later) when stratified by age (greater than 85%, 5–year event–free survival P=0.85); however, more events occurred with older external beam radiation treatment regimens (1993–2003) (70% to 75%, 5–year event–free survival P=0.001).