Journal article
The high prevalence of undiagnosed prostate cancer at autopsy: implications for epidemiology and treatment of prostate cancer in the Prostate-specific Antigen-era
International journal of cancer, v 137(12), pp 2795-2802
15 Dec 2015
PMID: 25557753
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Widespread prostate-specific antigen (PSA) screening detects many cancers that would have otherwise gone undiagnosed. To estimate the prevalence of unsuspected prostate cancer, we reviewed 19 studies of prostate cancer discovered at autopsy among 6,024 men. Among men aged 70-79, tumor was found in 36% of Caucasians and 51% of African-Americans. This enormous prevalence, coupled with the high sensitivity of PSA screening, has led to the marked increase in the apparent incidence of prostate cancer. The impact of PSA screening on clinical practice is well-recognized, but its effect on epidemiologic research is less appreciated. Before screening, a larger proportion of incident prostate cancers had lethal potential and were diagnosed at advanced stage. However, in the PSA era, overall incident prostate cancer mainly is indolent disease, and often reflects the propensity to be screened and biopsied. Studies must therefore focus on cancers with lethal potential, and include long follow-up to accommodate the lead time induced by screening. Moreover, risk factor patterns differ markedly for potentially lethal and indolent disease, suggesting separate etiologies and distinct disease entities. Studies of total incident or indolent prostate cancer are of limited clinical utility, and the main focus of research should be on prostate cancers of lethal potential.
Metrics
Details
- Title
- The high prevalence of undiagnosed prostate cancer at autopsy: implications for epidemiology and treatment of prostate cancer in the Prostate-specific Antigen-era
- Creators
- Jaquelyn L Jahn - Brigham and Women's HospitalEdward L Giovannucci - Brigham and Women's HospitalMeir J Stampfer - Brigham and Women's Hospital
- Publication Details
- International journal of cancer, v 137(12), pp 2795-2802
- Publisher
- Wiley
- Grant note
- UM1 CA167552 / NCI NIH HHS P50 CA090381 / NCI NIH HHS R01 CA133891 / NCI NIH HHS 5R01CA141298 / NCI NIH HHS R01 CA141298 / NCI NIH HHS R01CA133891 / NCI NIH HHS 5P50CA090381-08 / NCI NIH HHS CA167552 / NCI NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000362843300006
- Scopus ID
- 2-s2.0-84943661719
- Other Identifier
- 991021448062904721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Oncology