Prostate cancer survival rates improved since introduction of PSA testing

August 23, 2012, Elsevier

The routine use of prostate specific antigen (PSA) testing for screening and monitoring prostate cancer has led to early and more sensitive detection of the disease. A new study published in The Journal of Urology reports that in the "PSA era," survival has improved for patients with newly diagnosed prostate cancer that has spread to the bones or other parts of the body and the disparity between African American and Caucasian men has been resolved.

"Our analysis indicates an overall improvement in risk adjusted rates for non-African American and . Of note is the resolution of disparity in survival between the races found in earlier studies," says lead investigator Ian M. Thompson, Jr., MD, Director of the and Research Center, a -Designated Cancer Center, and Professor in the Department of Urology at the UT Health Science Center at San Antonio, TX.

The Southwest Oncology Group, a National Cancer Institute (NCI) sponsored organization that conducts clinical trials in adult cancers, has performed a series of clinical trials over the that evaluated patient survival after androgen deprivation treatment (ADT) for . Two of the trials took place before, and one took place after the introduction of PSA screening. "These sequential trials provide an opportunity to address the question of whether survival has improved since the advent of widespread PSA screening and follow-up testing," says Dr. Thompson. Patient populations and eligibility criteria were comparable across the three studies, which enrolled patients from cancer centers around the country. Patients in all three trials received similar ADT treatments.

Median survival in trial S8494, which enrolled patients from 1985 to 1986, was 30 months, and median survival in trial S8894, which enrolled patients from 1989 to 1994, was 33 months. In contrast, median survival in trial S9346, which enrolled patients from 1995 to 2009, was 49 months. A 30% decreased risk of death was found in the most recent trial (S9346) from the previous trial (S8894).

The interaction of various risk factors, such as extensive versus minimal disease, older age, race, and body mass index was assessed. In S8494 the median survival for African American men was 27 months, while in S9346, the survival rate was 48 months, which is very close to that of white men.

Dr. Thompson notes that African American men had poorer results in the earlier studies despite receiving treatment in a carefully overseen clinical trial. "When we evaluated ZIP code summary information regarding income and education, there was no shift in socioeconomic status over time. We hypothesize that this improvement is based on greater awareness of prostate cancer and improved health seeking behavior in African American men." However, African American men have a two- to three-fold greater incidence of newly diagnosed metastatic prostate cancer compared to white men, which contributes to a similarly increased mortality rate. "A greater effort is needed to eliminate disparities in prostate cancer," he says.

Dr. Thompson concludes, "While not all of these welcome improvements can be attributed strictly to PSA testing, without a doubt it has played a role in extending many lives."

Explore further: More aggressive treatment not necessary for men with a family history of prostate cancer

More information: “Improved Overall Survival Trends of Men with Newly Diagnosed M1 Prostate Cancer: A SWOG Phase III Trial Experience (S8494, S8894 and S9346),” C.M. Tangen, M.H.A. Hussain, C.S. Higano et al. (DOI: 10.1016/j.juro.2012.06.046). It appears online in advance of publication in The Journal of Urology, Volume 188, Issue 4 (October 2012)

Related Stories

More aggressive treatment not necessary for men with a family history of prostate cancer

October 5, 2011
Approximately 10-20 percent of prostate cancer patients have a family history of the disease. There are three major factors that are used to evaluate the extent and aggressiveness of prostate cancer, help make treatment decisions, ...

PSA screening to detect prostate cancer can be beneficial to younger and at-risk men: study

May 7, 2012
Screening younger men and men at risk of prostate cancer can be beneficial in reducing metastatic cancer and deaths and should not be abandoned, states an article published in CMAJ (Canadian Medical Association Journal).

Recommended for you

How cancer metastasis happens: Researchers reveal a key mechanism

January 18, 2018
Cancer metastasis, the migration of cells from a primary tumor to form distant tumors in the body, can be triggered by a chronic leakage of DNA within tumor cells, according to a team led by Weill Cornell Medicine and Memorial ...

Modular gene enhancer promotes leukemia and regulates effectiveness of chemotherapy

January 18, 2018
Every day, billions of new blood cells are generated in the bone marrow. The gene Myc is known to play an important role in this process, and is also known to play a role in cancer. Scientists from the German Cancer Research ...

These foods may up your odds for colon cancer

January 18, 2018
(HealthDay)—Chowing down on red meat, white bread and sugar-laden drinks might increase your long-term risk of colon cancer, a new study suggests.

The pill lowers ovarian cancer risk, even for smokers

January 18, 2018
(HealthDay)—It's known that use of the birth control pill is tied to lower odds for ovarian cancer, but new research shows the benefit extends to smokers or women who are obese.

Researchers develop swallowable test to detect pre-cancerous Barrett's esophagus

January 17, 2018
Investigators at Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center have developed a simple, swallowable test for early detection of Barrett's esophagus that offers promise ...

Scientists zoom in to watch DNA code being read

January 17, 2018
Scientists have unveiled incredible images of how the DNA code is read and interpreted—revealing new detail about one of the fundamental processes of life.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.