Screening at the Population Level Trends in Incidence and Mortality

Prostate cancer screening, especially screening with serum PSA in the late 1980s and early 1990s, has profoundly increased the age-adjusted incidence of diagnosed prostate cancer in the United States. Steady rises in the 1970s and early l980s can be attributed to an increase in the number of transurethral resections of the prostate (TURPs) for benign prostatic hyperplasia.2 The subsequent acceleration of incidence can be attributed to increasing use of PSA.3 It should be noted that the use of...

Diagnosis by Biopsy the Gold Standard

Biopsy represents the gold standard of prostate cancer diagnosis. There is no better proof of the presence of a cancer than the histologic evidence. It is clear that the incidence of PCa is influenced by the method of prostate sampling. The real incidence of prostate cancer is unknown, as is the natural history concerning size and location within the prostate. In a small series of radical cystoprostatectomy specimens, removed for urothelial carcinoma, small volume prostate cancers were found in...

The Classic Three Prostate Specific Antigen Digital Rectal Examination Transrectal Ultrasonography

Various diagnostic modalities are discussed below, starting with the classic three PSA, DRE, and TRUS. Most early detection efforts focused on these modalities, and each of them was at some time thought to be useful as an independent screening tool. In these studies, younger age was excluded from analysis, based on the clinical presentation of prostate cancer. Age, however turned out to be a valuable tool, especially in relation to PSA, and will be discussed in the section on prostate volume...

Free to Total PSA Ratio

One of the more recent PSA derivatives is the comparison of unbound free PSA to the total amount of PSA in the serum. The PSA can exist as free PSA and as PSA bound to Od-antichymotrypsin ACT or a2-macroglobulin A2M .43'44 The PSA bound to A2M PSA-A2M is anti-genically shielded and not measurable by any PSA assay. The PSA-ACT complex, however, is immunoreactively unique and can be measured in the serum as a separate moiety. As a result, it is possible to compare the amount of free PSA to the...

Racial Ethnic Epidemiologic Statistics

The clinical incidence of prostate cancer reported by the American Cancer Society in 1997 was 66 higher among African American men than among Caucasian men.9 In the past, the clinical incidence of prostate cancer has ranged from 30 to 50 higher among African Americans than among Caucasians. Also, there have been variations among the two groups in the lifetime risk of being diag nosed with prostate cancer. In 1993, 1 of 11 African Americans was diagnosed with prostate cancer compared to 1 of 9...

Androgen Receptor GGC Repeats

In addition to containing a polymorphic CAG repeat in the transactivation domain, exon one of the androgen receptor also contains a polymorphic GGC repeat. The GGC repeat encodes for a variable number of glycines and is located approximately 1.1 kilobases 3' of the CAG repeat. The variable GGC repeat 4 to 24 triplets follows an invariant GGT 3GGG GGT 2 repeat that also encodes for six consecutive glycines. The median and mean GGC repeat length are both approximately 16.9,10 Unpublished...

Isbn 1550091026

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