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Prostate cancer screening: New data support watchful waiting
Date:8/13/2013

PHILADELPHIA Prostate cancer aggressiveness may be established when the tumor is formed and not alter with time, according to a study published in Cancer Research, a journal of the American Association for Cancer Research.

Researchers found that after the introduction of widespread prostate-specific antigen (PSA) screening, the proportion of patients diagnosed with advanced-stage cancers dropped by more than six-fold in 22 years, but the proportion diagnosed with high Gleason grade cancers did not change substantially. This suggests that low-grade prostate cancers do not progress to higher grade over time.

Cancer stage refers to the extent or spread of the disease, and cancer grade, called Gleason grade for prostate cancer, refers to the aggressiveness of the disease.

"We were able to look at finely stratified time periods to capture pre-PSA, early-PSA, and late-PSA eras within one study. Over time, because of PSA screening, men have been more likely to be diagnosed with prostate cancer at an earlier stage, before the disease has had an opportunity to grow and spread. If Gleason grade also progressed over time, we would expect a similar decrease in high Gleason grade disease over time," said Kathryn Penney, Sc.D., instructor in medicine at the Harvard Medical School and associate epidemiologist at the Channing Division of Network Medicine at Brigham and Women's Hospital in Boston, Mass. "We were surprised by just how constant the incidence of high-grade disease has been over time."

This study adds more evidence to the argument that patients who are diagnosed with low-grade prostate cancers can opt for an active surveillance, or "watch and wait" approach instead of getting treated right away.

Penney and colleagues used data from 420 participants recruited to the Physicians' Health Study and 787 participants recruited to the ongoing Health Professionals Follow-up Study. All participants were diagnosed with pr
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Contact: Jeremy Moore
jeremy.moore@aacr.org
215-446-7109
American Association for Cancer Research
Source:Eurekalert

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