Words of Wisdom. Re: prostate specific antigen concentration at age 60 and death or metastasis from prostate cancer: case-control study.

摘要

The authors evaluated prostate-specific antigen (PSA) in blood samples collected in 1981 from a cohort of 1167 Swedish men who were 60 yr old. PSA results were matched with information from the cancer registry at the National Board of Health and Welfare in Sweden to identify in this cohort men who have been diagnosed with prostate cancer (PCa) by age 85. The main outcome measures were metastasis or death from PCa. The authors observed that PSA level at age 60 predicts lifetime risk of clinically detected PCa, metastasis, and death from the disease. The association between PSA and death from PCa is stronger than the association between PSA and cancer detected at biopsy. Men with PSA concentrations <1 ng/ml at age 60 had a 0.5% probability of metastasis by age 85 and a 0.2% probability of death from PCa. Conversely, a level close to 5 ng/ml predicts a 19% risk of developing metastatic PCa and a 17% risk of dying from the disease.