Baseline PSA and Risk of Prostate Cancer Diagnosis
Principal Investigator
Name
Amanda Black
Degrees
Ph.D, M.P.H.
Institution
NCI
Position Title
Associate Director
Email
About this CDAS Project
Study
PLCO
(Learn more about this study)
Project ID
PLCO-400
Initial CDAS Request Approval
Sep 12, 2018
Title
Baseline PSA and Risk of Prostate Cancer Diagnosis
Summary
This is an update to the PLCO project 2008-0036: Baseline PSA and 7 Year Risk of Prostate Cancer Diagnosis.
Considerable controversy still remains over the use of PSA screening for the early detection of prostate cancer. Where the American Cancer Society and the American Urological Association recommend annual screening for prostate cancer, using PSA testing and digital rectal examinations, the UK has no such recommendations. The PCPT has demonstrated that there is no 'normal' PSA but rather a continuum of risk of prostate cancer based on the individual's PSA level. This contributes to the uncertainty of the most appropriate level, and how intensively, to investigate low PSA levels. There is a need to balance over-diagnosis of prostate cancer with identification of clinically significant cancers. To allow men to make a fully informed choice when both considering and following a PSA test, they must be aware of the outcomes associated with their options. The US PCPT and PLCO cancer trials and the Northern Ireland PSA study have all attained at least 7 years of follow-up for all study participants since their baseline PSA test. These studies offer the opportunity to compare the risk of prostate cancer diagnosis in a variety of environments (biopsy all, annual screening, non-screening).
Considerable controversy still remains over the use of PSA screening for the early detection of prostate cancer. Where the American Cancer Society and the American Urological Association recommend annual screening for prostate cancer, using PSA testing and digital rectal examinations, the UK has no such recommendations. The PCPT has demonstrated that there is no 'normal' PSA but rather a continuum of risk of prostate cancer based on the individual's PSA level. This contributes to the uncertainty of the most appropriate level, and how intensively, to investigate low PSA levels. There is a need to balance over-diagnosis of prostate cancer with identification of clinically significant cancers. To allow men to make a fully informed choice when both considering and following a PSA test, they must be aware of the outcomes associated with their options. The US PCPT and PLCO cancer trials and the Northern Ireland PSA study have all attained at least 7 years of follow-up for all study participants since their baseline PSA test. These studies offer the opportunity to compare the risk of prostate cancer diagnosis in a variety of environments (biopsy all, annual screening, non-screening).
Aims
This would be a two-phase project. The first phase would involve investigation of the risk of prostate cancer diagnosis based on baseline PSA after 7 years of follow-up in PLCO. Aim 1.To investigate the 7 year risk of prostate cancer diagnosis and grade of disease based on baseline PSA measurements in men undergoing screening in the PLCO trial. The second phase would seek to retrieve raw data from PCPT collaborators and NI collaborators . Aim 2. To compare the risk of prostate cancer diagnosis and grade of disease following 7 years of follow-up after baseline PSA test in 3 differing environments: biopsy all men (PCPT), screening (PLCO), non-screened population (NI).
Collaborators
tbd
Related Publications
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Risk of Prostate Cancer-related Death Following a Low PSA Level in the PLCO Trial.
Landy R, Houghton LC, Berg CD, Grubb RL, Katki HA, Black A
Cancer Prev Res (Phila). 2020 Jan 29 PUBMED