Zaina Qureshi

South Carolina College of Pharmacy, University of South Carolina

PLCO (Learn more about this study)

2011-0087

May 19, 2011

Screening interval based on initial PSA: Data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial

Introduction: The value of early detection of prostate cancer remains to be established. However, PSA screening is commonplace and is generally conducted on an annual basis. The effects of a change in screening patterns are unknown. Purpose: The purpose of this study is to assess the consequences and costs of Prostate Cancer screening and establish the most cost effective screening guidelines for prostate cancer.Materials and Methods: The PLCO Trial is a large controlled trial that recruited 76,693 men aged 55-74, and randomized them to a screening arm or usual care arm. PSA will be determined at screening rounds. A prostate cancer will be considered to be screen-detected if it was diagnosed following a positive PSA screening exam. All men who have a PSA =4ng/mL at baseline and at least one subsequent test will be included. We will evaluate changes in PSA for each year over 5 years among men in the screening arm who had baseline PSA levels ranging from < 1ng/ml to = 4 ng/mL and at least one subsequent PSA exam. The cumulative proportion of men who convert from PSA =4 ng/mL at baseline to PSA >4 ng/mL at years 1 through 5 will be determined. Only those cancers with available Gleason grading will be included. A PSA level of >4ng/mL will be considered positive for prostate cancer. Gleason scores of >6 will be considered aggressive. A Kaplan-Meier will be used to estimate the cumulative proportion of men converting to a PSA above 4 ng/mL during the screening rounds. Cost saved due to increase in PSA screening intervals will be analyzed.