Differences between men with screening-detected versus clinically diagnosed prostate cancers in the USA

Richard M Hoffman; S Noell Stone; David Espey; Arnold L Potosky

doi:10.1186/1471-2407-5-27

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Differences between men with screening-detected versus clinically diagnosed prostate cancers in the USA

Journal article

Open access

Peer reviewed

Differences between men with screening-detected versus clinically diagnosed prostate cancers in the USA

Richard M Hoffman, S Noell Stone, David Espey and Arnold L Potosky

BMC cancer, Vol.5(1), pp.27-27

03/08/2005

DOI: 10.1186/1471-2407-5-27

PMCID: PMC555747

PMID: 15755329

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Abstract

The advent of prostate specific antigen (PSA) testing in the United States of America (USA) has led to a dramatic increase in the incidence of prostate cancer in the United States as well as the number of men undergoing aggressive treatment with radical prostatectomy and radiation therapy. We compared patient characteristics and treatment selection between American men with screening-detected versus clinically diagnosed prostate cancers. We evaluated 3,173 men with prostate cancer in the USA. Surveys and medical records provided information on demographics, socioeconomic status, comorbidities, symptoms, tumor characteristics, and treatment. We classified men presenting with symptoms of advanced cancer - bone pain, weight loss, or hematuria - as "clinically diagnosed"; asymptomatic men and those with only lower urinary tract symptoms were considered "screening-detected." We used multivariate analyses to determine whether screening predicted receiving aggressive treatment for a clinically localized cancer. We classified 11% of cancers as being clinically diagnosed. Men with screening-detected cancers were more often non-Hispanic white (77% vs. 65%, P < 0.01), younger (36% < 65 years vs. 25%, P <or= 0.01), better educated (80% >or= high school vs. 67%, P < 0.01), healthier (18% excellent health vs. 10%, P < 0.01), and diagnosed with localized disease (90% vs. 75%, P < 0.01). Men with screening-detected localized cancers more often underwent aggressive treatment, 76% vs. 70%, P = 0.05. Most cancers were detected by screening in this American cohort. Appropriately, younger, healthier men were more likely to be diagnosed by screening. Minority status and lower socio-economic status appeared to be screening barriers. Screening detected earlier-stage cancers and was associated with receiving aggressive treatment.

Multivariate Analysis

United States - epidemiology

Humans

Middle Aged

Mass Screening - statistics & numerical data

Male

Aged

Prostatic Neoplasms - diagnosis

Social Class

Cohort Studies

Prostatic Neoplasms - epidemiology

Prostatic Neoplasms - therapy

Details

Title: Subtitle: Differences between men with screening-detected versus clinically diagnosed prostate cancers in the USA
Creators: Richard M Hoffman - Medicine Service, New Mexico VA Health Care System, Albuquerque, New Mexico, USA. rhoffman@unm.edu
S Noell Stone
David Espey
Arnold L Potosky
Resource Type: Journal article
Publication Details: BMC cancer, Vol.5(1), pp.27-27
DOI: 10.1186/1471-2407-5-27
PMID: 15755329
PMCID: PMC555747
NLM abbreviation: BMC Cancer
ISSN: 1471-2407
eISSN: 1471-2407
Grant note: N01 PC067010 / NCI NIH HHS N01PC67007 / NCI NIH HHS N01PC67005 / NCI NIH HHS N01PC67000 / NCI NIH HHS N01 CN067009 / NCI NIH HHS N01PC67010 / NCI NIH HHS N01 PC067006 / NCI NIH HHS U48/CCU610818-06-4 / ODCDC CDC HHS
Language: English
Date published: 03/08/2005
Academic Unit: Epidemiology; General Internal Medicine; Internal Medicine
Record Identifier: 9984094731702771

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