Optimal Starting Age and Baseline Level for Repeat Tests: Economic Concerns of PSA Screening for Chinese Men – 10-Year Experience of a Single Center
| Autor: | Lin Zhong, Cun-Dong Liu, Ming Xia, Jun-Hao Zhou, Li Lu, Jun Bian, Gang Xiao, Jian-Kun Yang, Qi-Zhao Zhou, Ji-Ming Bao, Wen-Bing Guo, Cheng Yang, Yang Liu, Jia-Wei Zhou, Mingkun Chen, Qing-Zhu Wei, Kang-Yi Xue |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Psa screening Chinese men Psa testing Urology Population 030232 urology & nephrology Baseline level urologic and male genital diseases Single Center 03 medical and health sciences Prostate cancer 0302 clinical medicine Asian People Internal medicine medicine Humans education Early Detection of Cancer Aged Retrospective Studies Aged 80 and over PSA Velocity education.field_of_study business.industry Age Factors Prostatic Neoplasms Middle Aged Prostate-Specific Antigen medicine.disease 030220 oncology & carcinogenesis business |
| Zdroj: | Urologia Internationalis. 104:230-238 |
| ISSN: | 1423-0399 0042-1138 |
| DOI: | 10.1159/000503733 |
| Popis: | Objective: To investigate the optimal age for the baseline serum prostate-specific antigen (PSA) test and for repeat screening and its economic burden in a single center in China. Materials and Methods: 35,533 men with PSA screening were retrospectively enrolled in this study. Follow-ups were conducted in 1,586 men with PSA >4 ng/mL, and receiver-operating characteristic (ROC) curves were employed to investigate the optimal cutoffs. Results: ROC analysis indicated that the optimal age for initial PSA screening was 57.5 years (AUC = 0.84), 62.5 years (AUC = 0.902), 60.5 years (AUC = 0.909), and 61.5 years (AUC = 0.890) for individuals with PSA >4 and >10 ng/mL, a diagnosis of prostate cancer (PCa), and clinically significant PCa defined as the focus events, respectively. For Chinese men aged 50–59, 60–69, and >70 years, the initial PSA levels of 1.305 ng/mL (AUC = 0.699), 1.975 ng/mL (AUC = 0.711), and 2.740 ng/mL (AUC = 0.720) might have a PSA velocity >0.75 ng/mL per year during the follow-up. In addition, the total cost amounts to CNY 13,609,260 in these cases, but only 60 of the 35,533 (0.17%) men gained benefit from PSA screening. Conclusion: In our opinion, the optimal starting age for initial PSA testing was 57.5 years. The necessity for repeat screening should be based on the first PSA level depending on age. A cost-benefit analysis should be included in population-based screening. |
| Databáze: | OpenAIRE |
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