Published online May 25, 2009.
https://doi.org/10.4111/kju.2009.50.5.439
Changes in Prostate Cancer Pattern according to Prostate-Specific Antigen Screening Test
Abstract
Purpose
The aim of this study was to investigate the changes in the clinical and prognostic parameters of prostate cancer in Korean men in the eras before and after prostate-specific antigen (PSA) testing.
Materials and Methods
The medical records of 303 patients treated for prostate cancer between 1982 and 2005 were reviewed with respect to age, chief complaints, clinical stage, tumor grade, treatment options, and prognosis. We classified the patients as follows: those treated in the pre-PSA era (1982-1995, n=81), and those treated in the PSA era (1996-2000, PSA era phase 1, n=92; and 2001-2005, PSA era phase 2, n=130).
Results
There was no significant difference in age or clinical stage between patients treated before and those treated during the PSA era, although there was a downward migration of grade. The cancer-specific survival rates were also not different in all cases and in metastatic prostate cancer cases between the pre-PSA era and the PSA era, although the overall survival rates were significantly greater in all cases in phase 2 of the PSA era than in the pre-PSA era or in phase 1 of the PSA era (p<0.05). However, the cancer-specific survival rates for localized or locally advanced prostate cancer were significantly greater in phase 2 of the PSA era than in the pre-PSA era or in phase 1 of the PSA era (p<0.05).
Conclusions
We observed a downward migration of tumor grade, but there were no migrations in the age of patients or clinical stage, and these findings have not contributed to changes in the cancer survival of Korean men with prostate cancer after the advent of PSA testing.
Fig. 1
Kaplan-Meier survival curves of prostate cancer in the pre and post prostate-specific antigen (PSA) eras. (A) Overall survival curves of all cases. (B) Cancer-specific survival curves of all cases. (C) Cancer-specific survival curves of localized or locally advanced prostate cancer. (D) Cancer-specific survival curves of metastatic prostate cancer.
Table 1
Demographics of patients with prostate cancer in the pre and post PSA eras
Table 2
Comparison of treatment options in the pre and post PSA eras
Table 3
Cause of death (n=164)
Table 4
Cancer-specific survival rate according to clinical stage (%)
This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A085138).
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