Men Who Follow Recommended Testing Guidelines Do Better
That is, men who have followed guideline principles by having early (starting at the ages 40-50 years old) and regular PSA testing (at maximum, each PSA test within 18 months of each other).
If a man elects to undergo PSA testing, the AUA (American Urological Association) and the NCCN (National Comprehensive Cancer Network) recommend obtaining a baseline PSA at the age of 40. Then, urologists use the value of the baseline PSA to determine the correct screening interval.
Others, such as the ACS (American Cancer Society) recommend annual testing beginning between the ages 40 to 50, depending on individual risk factors such as family history and race.
Using medical records from 499 men diagnosed with prostate cancer, who visited Dr. Catalona’s Northwestern clinic and enrolled in his prostate cancer database, groups of men were divided based on their PSA screening history.
One group was men who followed the general guidelines for regular, annual testing. These men began their PSA testing between the ages 40 – 50 years old and had each PSA test within 18 months of each other before their diagnosis with prostate cancer.
The other group did not follow guidelines. These men began PSA testing at the age of 52 or later or had a 2-year or more hiatus in their testing prior to their diagnosis.
Men who did not follow the guideline’s principles were found to have higher biopsy Gleason Grade tumors compared to the men who did follow guidelines.
Also, those men who did not follow the guidelines had significantly more biochemical recurrence of their prostate cancer after their treatment.
In addition, per one-year increase in this delay or hiatus of PSA testing, there tended to show a 3% increase in risk for cancer recurrence after treatment. If the delay or hiatus was 5 years or greater, the risk of cancer recurrence increased to 52% compared to the men with less than a 5 year hiatus.
Following recommended guidelines also affected progression-free survival rates between the two groups. It was 85% for those who followed the guidelines versus 75% for those men that had a 5-year or greater hiatus or delay in their PSA testing.
Men who followed general recommendations for prostate cancer screening by beginning annual PSA testing at age 40 to 50 had significantly lower Gleason grade tumors on biopsy, less biochemical recurrence, and a 5-year progression-free survival rate that showed more significance the further the men diverged from guideline recommendations.
based upon presentation at May, 2011 AUA meeting: Regularity of PSA Testing and Cancer Recurrence in Prostate Cancer Patients James M. Dupree, MD; Jessica A. Banks; Bharat Thakkar, MD; Jessica T. Casey, MD; Dae Y. Kim, MD: Qiaoyan Hu; Stacy Loeb, MD; William J. Catalona, MD