Ito K, Kubota Y, Yamamoto T, Suzuki K, Fukabori Y, Kurokawa K, Yamanaka H
Department of Urology, Gunma University School of Medicine, 3-39-22 Showa-machi, Maebashi, 371-8511, Gunma, Japan.
Cancer. 2001 Feb 15;91(4):744-51.
Long term follow-up for subjects whose initial prostate specific antigen (PSA) levels were 4.0 ng/mL or lower was conducted to investigate the proper interval for PSA screening.
Eight thousand five hundred ninety-five men aged 50 years or older with an initial PSA level of 4.0 ng/mL or lower were screened with tumor marker measurement and/or digital rectal examination (DRE) and/or transrectal ultrasonography as a first step in the mass screening, and a prostate biopsy was performed for individuals with abnormal findings.
Cancer was detected in 0.18% (8 of 4526), 1.0% (27 of 2724), and 3.6% (49 of 1345) of men whose initial PSA levels were lower than 1.0, 1.0-1.9, and 2.0-4.0 ng/mL, respectively. Among these prostate carcinoma cases, 25% (6 of 8), 56% (15 of 27), and 63% (31 of 49) were detected by abnormal PSA in patients with initial PSA levels lower than 1.0, 1.0-1.9, and 2.0-4.0 ng/mL, respectively. The detection rates of prostate carcinoma within 3 years after the initial visit were 0.07%, 0.24%, and 1.2% in cases with initial PSA levels lower than 1.0, 1.0-1.9, and 2.0-4.0 ng/mL, respectively.
It is recommended that DRE and PSA measurements should be performed once every 3 years in individuals with initial PSA levels of less than 1.0 ng/mL. The prostate carcinoma detection rate increased over time in individuals with initial PSA levels of 1.0 to 4.0 ng/mL, especially in cases with 2.0-4.0 ng/mL, and annual measurement of PSA was more useful than DRE. Therefore, it is recommended that PSA screening should be performed once every year for individuals with initial PSA levels of 1.0 to 4.0 ng/mL.
对初始前列腺特异性抗原（PSA）水平为4.0 ng/mL或更低的受试者进行长期随访，以研究PSA筛查的合适间隔时间。
8595名年龄在50岁及以上、初始PSA水平为4.0 ng/mL或更低的男性作为大规模筛查的第一步，接受肿瘤标志物检测和/或直肠指检（DRE）和/或经直肠超声检查，对检查结果异常的个体进行前列腺活检。
初始PSA水平低于1.0、1.0 - 1.9和2.0 - 4.0 ng/mL的男性中，前列腺癌的检出率分别为0.18%（4526例中的8例）、1.0%（2724例中的27例）和3.6%（1345例中的49例）。在这些前列腺癌病例中，初始PSA水平低于1.0、1.0 - 1.9和2.0 - 4.0 ng/mL的患者中，分别有25%（8例中的6例）、56%（27例中的15例）和63%（49例中的31例）通过PSA异常检测出。初次就诊后3年内前列腺癌的检出率在初始PSA水平低于1.0、1.0 - 1.9和2.0 - 4.0 ng/mL的病例中分别为0.07%、0.24%和1.2%。
建议初始PSA水平低于1.0 ng/mL的个体每3年进行一次DRE和PSA检测。初始PSA水平为1.0至4.0 ng/mL的个体中，前列腺癌检出率随时间增加，尤其是在2.0 - 4.0 ng/mL的病例中，每年检测PSA比DRE更有用。因此，建议初始PSA水平为1.0至4.0 ng/mL的个体每年进行一次PSA筛查。
