Prevalence of Prostate Cancer among Men with a Prostate-Specific Antigen Level 4.0 ng per Milliliter
Ian M. Thompson, M.D., Donna K. Pauler, Ph.D., Phyllis J. Goodman, M.S., Catherine M. Tangen, Dr.P.H., M. Scott Lucia, M.D., Howard L. Parnes, M.D., Lori M. Minasian, M.D., Leslie G. Ford, M.D., Scott M. Lippman, M.D., E. David Crawford, M.D., John J. Crowley, Ph.D., and Charles A. Coltman, Jr., M.D.
Background The optimal upper limit of the normal range for prostate-specificantigen (PSA) is unknown. We investigated the prevalence ofprostate cancer among men in the Prostate Cancer PreventionTrial who had a PSA level of 4.0 ng per milliliter or less.
Methods Of 18,882 men enrolled in the prevention trial, 9459were randomly assigned to receive placebo and had an annualmeasurement of PSA and a digital rectal examination. Among these9459 men, 2950 men never had a PSA level of more than 4.0 ngper milliliter or an abnormal digital rectal examination, hada final PSA determination, and underwent a prostate biopsy afterbeing in the study for seven years.
ResultsAmong the 2950 men (age range, 62 to 91 years), prostatecancer was diagnosed in 449 (15.2 percent); 67 of these 449cancers (14.9 percent) had a Gleason score of 7 or higher. Theprevalence of prostate cancer was 6.6 percent among men witha PSA level of up to 0.5 ng per milliliter, 10.1 percent amongthose with values of 0.6 to 1.0 ng per milliliter, 17.0 percentamong those with values of 1.1 to 2.0 ng per milliliter, 23.9percent among those with values of 2.1 to 3.0 ng per milliliter,and 26.9 percent among those with values of 3.1 to 4.0 ng permilliliter. The prevalence of high-grade cancers increased from12.5 percent of cancers associated with a PSA level of 0.5 ngper milliliter or less to 25.0 percent of cancers associatedwith a PSA level of 3.1 to 4.0 ng per milliliter.
Conclusions Biopsy-detected prostate cancer, including high-gradecancers, is not rare among men with PSA levels of 4.0 ng permilliliter or less — levels generally thought to be inthe normal range.
When first described in 1979, prostate-specific antigen (PSA)was considered a useful marker for assessing treatment responsesand follow-up among patients with prostate cancer.1 After thepublication of reports on several series in which the need fora biopsy of the prostate was based on the results of PSA tests,the potential of the PSA level as a screening tool was recognized.2,3Further experience led to the consensus that a PSA level ofmore than 4.0 ng per milliliter had predictive value for thediagnosis of prostate cancer.4 Disease detection subsequentlyincreased dramatically.5 More recent data suggest that a PSAlevel of more than 2.5 ng per milliliter has a predictive valuesimilar to that of a value of 4.0 ng per milliliter or greater.6,7There are no prospective data on the predictive value of PSAin the range of 0.0 to 4.0 ng per milliliter.
We recently reported the results of the Prostate Cancer PreventionTrial, which investigated whether finasteride could preventprostate cancer.8 Owing to the finasteride-related decreasein PSA levels, and thus the drug's effect on the rate of detectionof prostate cancer over the seven-year study period, an essentialelement of the study was an end-of-study biopsy in men receivingfinasteride or placebo. Here, we report the prevalence of prostatecancer among men in the placebo group of the Prostate CancerPrevention Trial who had a PSA level of 4.0 ng per milliliteror less.
Methods
The Prostate Cancer Prevention Trial was a phase 3, randomized,double-blind, placebo-controlled study designed to determinewhether treatment with 5 mg of finasteride per day could reducethe prevalence of prostate cancer during a seven-year period.The study was sponsored by the National Cancer Institute andconducted by the Southwest Oncology Group. A total of 18,882men underwent randomization. Eligibility criteria included aserum PSA level of no more than 3.0 ng per milliliter, a normaldigital rectal examination, an age of at least 55 years, anAmerican Urologic Association symptom score of less than 20(scores can range from 0 [no symptoms] to 35 [severe symptoms]),and no clinically significant coexisting conditions. Men underwentannual measurement of PSA and digital rectal examination. AllPSA measurements were performed in a central laboratory withthe use of the Tandem E assay (Hybritech) until 2000 and theAccess assay (Beckman Coulter) subsequently. During the seven-yearstudy, a PSA level of more than 4.0 ng per milliliter or anabnormal digital rectal examination prompted a recommendationfor prostate biopsy. At the end of seven years, participantswithout a diagnosis of prostate cancer were scheduled to undergoan end-of-study prostate biopsy in which a minimum of six sampleswere obtained. All participants gave written informed consent.The details of the study have been provided previously.8,9,10
Prostate-biopsy specimens were reviewed by a pathologist atthe Core Pathology Laboratory (University of Colorado HealthScience Center, Denver), as well as by a pathologist at theparticipant's institution. Disagreements were resolved by athird pathologist, and consensus was achieved.
To ensure that the analysis of the prevalence of prostate canceramong men with a PSA level of 4.0 ng per milliliter or lesswould be applicable to the general population, only the placebogroup of the Prostate Cancer Prevention Trial was used for thisanalysis. We selected participants in the placebo group whoduring the trial never had a PSA level of more than 4.0 ng permilliliter or an abnormal digital rectal examination and neverunderwent a prostate biopsy or a transurethral resection ofthe prostate over the course of the seven-year study, but whodid undergo a biopsy at the end of the study. A PSA test musthave been performed either on the day of the end-of-study biopsy,but before the biopsy itself, or within 90 days before the biopsy.
Associations between base-line characteristics and prostatecancer were assessed with the use of chi-square tests with Yates'correction. Student's t-test was used to compare PSA valuesbetween men with biopsy-proved prostate cancer and men withoutprostate cancer on biopsy. Logistic-regression analyses of therisk of prostate cancer and high-grade disease (as defined bya Gleason score of 7 or greater) were performed with the useof the following variables: age in years, presence or absenceof a family history of prostate cancer (considered to be presentif the man's brother, father, or son had prostate cancer), race(black or other), and PSA level. The positive predictive valueof the PSA level for the detection of prostate cancer (or high-gradedisease) was defined as the probability that prostate cancer(or high-grade disease) would be found if the PSA level waswithin a prespecified range, such as 3.1 to 4.0 ng per milliliter.
Results
Of the 9459 men who were randomly assigned to the placebo group,2 had received a diagnosis of prostate cancer before enrollmentand 1242 men either had died before the end of the study orhad never undergone an end-of-study biopsy because of the earlyclosure of the trial. Among the remaining 8215 men, 1187 wereexcluded from the analysis because they had at least one PSAvalue above 4.0 ng per milliliter, and 3460 men were excludedbecause they had at least one abnormal digital rectal examination,underwent a transurethral resection of the prostate during thetrial, had off-study use of finasteride, or underwent an end-of-studybiopsy or had a final PSA measurement neither of which met thetiming requirements of the study. Of the remaining 3568 menwho were potentially eligible, 618 (17.3 percent) declined toundergo the biopsy. Thus, 2950 men (age range, 62 to 91 years)were included in the analysis.
Table 1 lists the characteristics of the participants, includingthe men who did not undergo an end-of-study biopsy but otherwisemet all criteria for the analysis. A significantly higher proportionof men who declined to undergo biopsy than who consented wereolder than 75 years of age (P<0.001). The average numberof PSA measurements for the 2950 men in the analysis was 7.9(median, 8), and 96.2 percent of the men had 7 or more PSA measurements.The average number of PSA measurements among the 618 men whodeclined to undergo the end-of-study biopsy but who met allother criteria for the analysis was 7.7 (median, 8), and 91.3percent of these men had 7 or more PSA measurements.
Table 1. Characteristics of the Men According to Whether They Underwent the End-of-Study Biopsy and to the Findings on Biopsy.
Of the 2950 men, 449 (15.2 percent) had prostate cancer on theend-of-study biopsy (Table 1). The percentage of cancers foundamong men who underwent a sextant biopsy — in which sixsamples were obtained and which was performed in 84.5 percentof the men — did not differ significantly from the percentageof cancers found in men whose biopsy included more than sixsamples (15.0 percent and 16.6 percent, respectively). A familyhistory of prostate cancer was significantly associated withan increased risk of prostate cancer, but the age at biopsyand race or ethnic group were not (Table 1). Our inclusion onlyof men who were at least 62 years old (eligibility for the ProstateCancer Prevention Trial required an age of at least 55 years)and our exclusion of men with PSA levels above 4.0 ng per millilitermay have made it impossible to detect any associations betweenage and the risk of cancer, since both PSA levels and the riskof prostate cancer increase with age. Detecting associationsbetween race and ethnic group and the risk of cancer may havebeen prevented by the limited numbers of blacks and membersof other minority groups in our study. The inability to assessblack men adequately is an important limitation of our studybecause of differences in the natural history of prostate cancer:the disease occurs earlier among blacks than whites and is ata more advanced stage when it is detected, but the stage-specificprognoses are similar between blacks and whites.
All 449 prostate cancers for which information on the stagewas available were stage T1; however, such information was missingfor 30 cancers (6.7 percent). Of the 449 cancers, 12 (2.7 percent)had Gleason scores of 2 to 4, 349 (77.7 percent) had scoresof 5 or 6, 67 (14.9 percent) had scores of 7 to 9, and 21 (4.7percent) were not graded. None of the tumors had a Gleason scoreof 10.
The mean (±SD) PSA value was 1.78±0.92 ng permilliliter among the 449 men with prostate cancer and 1.34±0.86ng per milliliter among the 2501 men without cancer (P<0.001).Figure 1 shows the distribution of PSA levels in the two groups.The annual increase in the PSA level during the seven yearsof the study, which was computed by means of linear regression(range, 0.32 to 0.46 ng per milliliter per year), was positivelyassociated with the risk of prostate cancer (P<0.001). Themean ratio of the PSA level to the volume of the prostate wasslightly higher among men with cancer (0.06±0.03) thanamong men without cancer (0.04±0.06), but the associationwas not significant.
Figure 1. Distributions of Prostate-Specific Antigen (PSA) Values According to the Gleason Score among Men with Prostate Cancer Detected on End-of-Study Biopsy and Men with No Cancer Detected on Biopsy.
The horizontal white lines within the boxes denote the medians, and the boxes span the 25th and 75th percentiles of the distributions. The vertical lines above and below each box indicate the range of the distribution. The width of each box is proportional (although not directly) to the number of men in the corresponding group. Twenty-one cancers were not graded.
Table 2 shows that the risk of prostate cancer increased from6.6 percent for PSA values of 0.5 ng per milliliter or lessto 26.9 percent for PSA values of 3.1 to 4.0 ng per milliliter.Logistic-regression analysis showed that the PSA level had asignificant effect on the risk of prostate cancer (odds ratiofor prostate cancer, 1.66 per unit increase in the PSA level;95 percent confidence interval, 1.50 to 1.85; P<0.001). Figure 2shows the relation between the PSA level and the risk of prostatecancer. In a multivariate analysis, a family history of prostatecancer was significantly associated with the risk of prostatecancer (odds ratio, 1.39; 95 percent confidence interval, 1.07to 1.79; P=0.01), as was an increase in the PSA level (oddsratio, 1.65 per unit increase; 95 percent confidence interval,1.48 to 1.83; P<0.001).
Figure 2. Estimated Risk of Prostate Cancer and High-Grade Disease as a Function of the Prostate-Specific Antigen (PSA) Level.
High-grade disease was defined by a Gleason score of 7 or greater.
The relation between the PSA level and the Gleason score isshown in Table 2 and Figure 1, Figure 2, and Figure 3. Althoughthe risk of high-grade disease increased with increasing PSAlevels, there was considerable overlap in the distributionsof PSA levels among the grades.Figure 2 shows predictions ofthe risk of high-grade disease on the basis of a logistic model.There was a significant correlation between the PSA level andhigh-grade disease (odds ratio, 2.10 per unit increase in thePSA level; 95 percent confidence interval, 1.66 to 2.65; P<0.001).The association persisted when cancers with a Gleason scoreof 7 (3+4 — the sum of the primary [most prevalent] gradeand the highest secondary grade) were excluded (odds ratio forhigh-grade disease, 1.80 per unit increase in the PSA level;95 percent confidence interval, 1.17 to 2.77; P=0.02). In amultivariate analysis, there was an additional significant associationwith black race (odds ratio for high-grade disease, 4.14; 95percent confidence interval, 1.77 to 9.68; P=0.001). The oddsratio for high-grade disease in the multivariate analysis was2.08 per unit increase in the PSA level (95 percent confidenceinterval, 1.64 to 2.64; P<0.001).
Figure 3. Prostate-Specific Antigen (PSA) Values among the 449 Men with Prostate Cancer, According to the Gleason Score.
Median PSA values are denoted by horizontal lines. A single cancer with a Gleason score of 2 is included in the group with a Gleason score of 4. Twenty-one cancers were not graded. There were no cancers with a Gleason score of 10. Of 60 cancers with a Gleason score of 7, 48 had a Gleason score of 3+4 and 12 a score of 4+3.
Discussion
PSA was first described in 1979, and its use suggested for theevaluation of treatment responses in men with prostate cancer.Early observations suggested that the PSA level might not beuseful for screening,11 and a level of 2.6 ng per milliliterwas proposed as the upper limit of the normal range.12,13,14,15Because of concern about the specificity of the test, otherearly reports suggested that the upper limit of the normal rangefor prostate-cancer screening should be 7.5 to 10.0 ng per milliliter.16,17
Before the advent of the PSA test, prostate cancer was usuallydiagnosed by means of digital rectal examination, which oftendetected cancer after the disease had spread.18 If a digitalrectal examination was abnormal, prostate biopsy with digitalguidance was usually performed, often with four or fewer biopsysamples obtained. The morbidity associated with the procedurewas substantial.19 In the mid-1980s, the use of ultrasound-guidedbiopsies with an automated, 18-gauge biopsy "gun" increasedthe safety and speed of the technique.20,21
In one of the first reported evaluations of PSA screening (in1653 men), prostate cancer was detected in 22 percent of themen (19 of 85) who underwent a biopsy because of a PSA levelof 4.0 to 9.9 ng per milliliter and in 67 percent of the men(18 of 27) who underwent a biopsy because of a PSA level ofmore than 10.0 ng per milliliter.2 In a subsequent study of1249 men, prostate cancer was found in 26 percent of the men(23 of 87) who underwent a biopsy because of a PSA level of4.1 to 10.0 ng per milliliter and in 50 percent of the men (9of 18) who underwent a biopsy because of a PSA level of morethan 10.0 ng per milliliter.3 After these initial reports ofPSA screening, there was a dramatic increase in the detectionof prostate cancer.
The positive predictive value of a PSA level of less than 4.0ng per milliliter is not well defined. A multi-institutional,prospective study of PSA levels and digital rectal examinationin 6630 men who were 50 years of age or older suggested thata value of 4.0 ng per milliliter should be used as the upperlimit of the normal range.22 In that study, only men with aPSA level of more than 4.0 ng per milliliter were offered aprostate biopsy unless they had an abnormal digital rectal examination.There are limited data on the prevalence of prostate canceramong men with a PSA level of 4.0 ng per milliliter or lessand, in particular, among men with levels below 2.5 ng per milliliter.One study showed that the rate of detection of clinically importantprostate cancer among men with a PSA level of 2.6 to 4.0 ngper milliliter was the same as that among men with PSA valuesof more than 4.0 ng per milliliter.7 The determination of anappropriate upper limit of the normal range for PSA screeningfor prostate cancer has been further confounded by changes inprostate-biopsy procedures. Although the initial standard forultrasound-guided prostate biopsy was to obtain 6 samples, morerecent studies have shown that obtaining 10 to 12 samples increasesthe detection rate.23
Given the lack of a rigorous evaluation of the optimal PSA levelfor the detection of prostate cancer and the changes in biopsytechnique, it is not surprising that the predictive value ofthe PSA level is not known. The end-of-study biopsies in theProstate Cancer Prevention Trial provided a unique opportunityto examine the predictive value of the PSA level in the rangeconsidered to be normal. We restricted our evaluation to menin the placebo group, because their PSA values were unaffectedby finasteride. The design of the Prostate Cancer PreventionTrial, including centralized pathological review and PSA measurementand the planned end-of-study biopsy, permitted this comprehensive,prospective evaluation of the prevalence of prostate canceramong men with a PSA level of 4.0 ng per milliliter or less.
With only six biopsy samples obtained from 84.5 percent of participantsand normal PSA levels (4.0 ng per milliliter or less) and digitalrectal examinations over a period of seven years in all men,our study cohort had a surprisingly high rate of biopsy-detectedprostate cancer: 15.2 percent. The rate of prostate cancer was10.1 percent among men with PSA levels of 0.6 to 1.0 ng permilliliter and rose to 26.9 percent among men with PSA levelsof 3.1 to 4.0 ng per milliliter. High-grade cancers (those witha Gleason score of at least 7) were observed throughout thisrange of PSA values and had an overall prevalence of 2.3 percent.The majority of cancers identified in men with a PSA level of4.0 ng per milliliter or less had a Gleason score of 6, a valuethat is reported to be associated with an increased risk ofdisease progression in the absence of treatment.24 Althoughthe risk of a finding of cancer on biopsy is directly relatedto PSA levels in the range of 0.0 to 4.0 ng per milliliter,there is no PSA value below which a man can be assured thathe has no risk of prostate cancer.
A major strength of our analysis is that it is not subject toverification bias, since the study included only men who underwentan end-of-study biopsy, unlike other studies, which includedfew men with a PSA level of less than 4.0 ng per milliliterwho underwent a prostate biopsy.25 Nevertheless, the implicationsof our results for current recommendations regarding prostatebiopsy are unclear. Our data indicate that high- or intermediate-gradeprostate cancer can be present in men with low PSA levels, despitethe impression of many clinicians that men with PSA levels of4.0 ng per milliliter or less (accounting for up to 92.4 percentof all men) have almost no risk of prostate cancer.26
Supported in part by Public Health Service grants (CA37429,CA35178, and CA45808) from the National Cancer Institute.
We are indebted to the 18,882 men who participated in this study;to the members of the data and safety monitoring committee;to the steering committee; to the study-site principal investigatorsand clinical research associates; to collaborators from theSouthwest Oncology Group, the Eastern Cooperative Oncology Group,and Cancer and Leukemia Group B; and to Merck for providingthe finasteride and the placebo.
Source Information
From the Division of Urology, Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio (I.M.T.); the Fred Hutchinson Cancer Research Center, Seattle (D.K.P., P.J.G., C.M.T.); the University of Colorado Health Science Center, Denver (M.S.L., E.D.C.); the Division of Cancer Prevention, National Cancer Institute, Bethesda, Md. (H.L.P., L.M.M., L.G.F.); the Department of Clinical Cancer Prevention, M.D. Anderson Cancer Center, Houston (S.M.L.); Cancer Research and Biostatistics, Seattle (J.J.C.); and the Southwest Oncology Group, San Antonio, Tex. (C.A.C.).
Address reprint requests to the Southwest Oncology Group (SWOG-9217), Operations Office, 14980 Omicron Dr., San Antonio, TX 78245-3217.
References
Wang MC, Valenzuela LA, Murphy GP, Chu TM. Purification of a human prostate specific antigen. Invest Urol 1979;17:159-163. [Web of Science][Medline]
Catalona WJ, Smith DS, Ratliff TL, et al. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med 1991;324:1156-1161. [Erratum, N Engl J Med 1991;325:1324.] [Abstract]
Brawer MK, Chetner MP, Beatie J, Buchner DM, Vessella RL, Lange PH. Screening for prostatic carcinoma with prostate specific antigen. J Urol 1992;147:841-845. [Web of Science][Medline]
Cooner WH, Mosley BR, Rutherford CL Jr, et al. Prostate cancer detection in a clinical urological practice by ultrasonography, digital rectal examination and prostate specific antigen. J Urol 1990;143:1146-1152. [Web of Science][Medline]
Brawley OW, Knopf K, Merrill R. The epidemiology of prostate cancer. I. Descriptive epidemiology. Semin Urol Oncol 1998;16:187-192. [Medline]
Labrie F, Candas B, Dupont A, et al. Screening decreases prostate cancer death: first analysis of the 1988 Quebec prospective randomized controlled trial. Prostate 1999;38:83-91. [CrossRef][Web of Science][Medline]
Krumholtz JS, Carvalhal GF, Ramos CG, et al. Prostate-specific antigen cutoff of 2.6 ng/mL for prostate cancer screening is associated with favorable pathologic tumor features. Urology 2002;60:469-473. [CrossRef][Web of Science][Medline]
Thompson IM, Goodman PJ, Tangen CM, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med 2003;349:215-224. [Free Full Text]
Thompson IM, Tangen C, Goodman P. The Prostate Cancer Prevention Trial: design, status, and promise. World J Urol 2003;21:28-30. [Medline]
Pauler DK, Gower KB, Goodman PJ, Crowley JJ, Thompson IM. Biomarker-based methods for determining noncompliance in a prevention trial. Control Clin Trials 2002;23:675-685. [Medline]
Ferro MA, Barnes I, Roberts JBM, Smith PJB. Tumour markers in prostatic carcinoma: a comparison of prostate-specific antigen with acid phosphatase. Br J Urol 1987;60:69-73. [Medline]
Kuriyama M, Wang MC, Papsidero LD, et al. Quantitation of prostate-specific antigen in serum by a sensitive enzyme immunoassay. Cancer Res 1980;40:4658-4662. [Free Full Text]
Liedtke RJ, Batjer JD. Measurement of prostate-specific antigen by radioimmunoassay. Clin Chem 1984;30:649-652. [Free Full Text]
Yang N. Diagnostic and prognostic application of prostate-specific tissue markers: prostate antigen (PA) and prostatic acid phosphatase (PAP). Clin Chem 1984;30:1057-1057. abstract.
Seamonds B, Yang N, Anderson K, Whitaker B, Shaw LM, Bollinger JR. Evaluation of prostate-specific antigen and prostatic acid phosphatase as prostate cancer markers. Urology 1986;28:472-479. [Medline]
Kuriyama M, Wang MC, Lee CL, et al. Multiple marker evaluation in human prostate cancer with the use of tissue-specific antigens. J Natl Cancer Inst 1982;68:99-105.
Pontes JE, Chu TM, Slack N, Karr J, Murphy GP. Serum prostatic antigen measurement in localized prostatic cancer: correlation with clinical course. J Urol 1982;128:1216-1218. [Web of Science][Medline]
Thompson IM, Ernst JJ, Gangai MP, Spence CR. Adenocarcinoma of the prostate: results of routine urological screening. J Urol 1984;132:690-692. [Web of Science][Medline]
Ruebush TK II, McConville JH, Calia FM. A double-blind study of trimethoprim-sulfamethoxazole prophylaxis in patients having transrectal needle biopsy of the prostate. J Urol 1979;122:492-494. [Medline]
Lee F, Gray JM, McLeary RD, et al. Transrectal ultrasound in the diagnosis of prostate cancer: location, echogenicity, histopathology, and staging. Prostate 1985;7:117-129. [Web of Science][Medline]
Ragde H, Aldape HC, Bagley CM Jr. Ultrasound-guided prostate biopsy: Biopty gun superior to aspiration. Urology 1988;32:503-506. [Medline]
Catalona WJ, Hudson MA, Scardino PT, et al. Selection of optimal prostate specific antigen cutoffs for early detection of prostate cancer: receiver operating characteristic curves. J Urol 1994;152:2037-2042. [Web of Science][Medline]
Levine MA, Ittman M, Melamed J, Lepor H. Two consecutive sets of transrectal ultrasound guided sextant biopsies of the prostate for the detection of prostate cancer. J Urol 1998;159:471-475. [CrossRef][Web of Science][Medline]
Albertsen PC, Hanley JA, Gleason DF, Barry MJ. Competing risk analysis of men aged 55 to 74 years at diagnosis managed conservatively for clinically localized prostate cancer. JAMA 1998;280:975-980. [Free Full Text]
Punglia RS, D'Amico AV, Catalona WJ, Roehl KA, Kuntz KM. Effect of verification bias on screening for prostate cancer by measurement of prostate-specific antigen. N Engl J Med 2003;349:335-342. [Free Full Text]
DeAntoni EP, Crawford ED, Oesterling JE, et al. Age- and race-specific reference ranges for prostate-specific antigen from a large community-based study. Urology 1996;48:234-239. [CrossRef][Medline]
Shibata A, Ma J, Whittemore AS. Prostate cancer incidence and mortality in the United States and the United Kingdom. J Natl Cancer Inst 1998;90:1230-1231. [Free Full Text]
Oliver SE, Gunnell D, Donovan JL. Comparison of trends in prostate-cancer mortality in England and Wales and the USA. Lancet 2000;355:1788-1789. [Erratum, Lancet 2000;356:1278.] [CrossRef][Web of Science][Medline]
Gohagan JK, Prorok PC, Hayes RB, Kramer BS. The Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial of the National Cancer Institute: history, organization, and status. Control Clin Trials 2000;21:Suppl:251S-272S. [CrossRef][Web of Science][Medline]
Sullivan PM, Etzioni R, Feng Z, et al. Phases of biomarker development for early detection of cancer. J Natl Cancer Inst 2001;93:1054-1061. [Free Full Text]
Prostate Cancer with Low PSA Levels
Beatty P. A., Glaser A. I., Rocco B., Matei D. V., de Cobelli O., Datta M. W., Berman J. J., Dhir R.
Extract |
Full Text |
PDF
N Engl J Med 2004;
351:1802-1803, Oct 21, 2004.
Correspondence
This article has been cited by other articles:
Izhak, L., Wildbaum, G., Uri, W., Shaked, Y., Alami, J., Dumont, D., Stein, A., Karin, N.
(2010). Predominant Expression of CCL2 at the Tumor Site of Prostate Cancer Patients Directs a Selective Loss of Immunological Tolerance to CCL2 That Could Be Amplified in a Beneficial Manner. J. Immunol.
184: 1092-1101
[Abstract][Full Text]
Romanuik, T. L., Ueda, T., Le, N., Haile, S., Yong, T. M.K., Thomson, T., Vessella, R. L., Sadar, M. D.
(2009). Novel Biomarkers for Prostate Cancer Including Noncoding Transcripts. Am. J. Pathol.
175: 2264-2276
[Abstract][Full Text]
Esserman, L., Shieh, Y., Thompson, I.
(2009). Rethinking Screening for Breast Cancer and Prostate Cancer. JAMA
302: 1685-1692
[Abstract][Full Text]
Marshall, J. R.
(2009). Keeping Our Eye on the Ball: The American Society of Preventive Oncology in 2009. Cancer Epidemiol. Biomarkers Prev.
18: 2796-2802
[Full Text]
Troyer, D. A., Lucia, M. S., de Bruine, A. P., Mendez-Meza, R., Baldewijns, M. M., Dunscomb, N., Van Engeland, M., McAskill, T., Bierau, K., Louwagie, J., Bigley, J. W.
(2009). Prostate Cancer Detected by Methylated Gene Markers in Histopathologically Cancer-Negative Tissues from Men with Subsequent Positive Biopsies. Cancer Epidemiol. Biomarkers Prev.
18: 2717-2722
[Abstract][Full Text]
Vilanova, J. C., Comet, J., Barcelo-Vidal, C., Barcelo, J., Lopez-Bonet, E., Maroto, A., Arzoz, M., Moreno, A., Areal, J.
(2009). Peripheral Zone Prostate Cancer in Patients with Elevated PSA Levels and Low Free-to-Total PSA Ratio: Detection with MR Imaging and MR Spectroscopy. Radiology
253: 135-143
[Abstract][Full Text]
Ilic, D., Green, S.
(2009). Prostate specific antigen for detecting early prostate cancer. BMJ
339: b3572-b3572
[Full Text]
Nelson, W. G., De Marzo, A. M., Yegnasubramanian, S.
(2009). Epigenetic Alterations in Human Prostate Cancers. Endocrinology
150: 3991-4002
[Abstract][Full Text]
Hillier, S. M., Maresca, K. P., Femia, F. J., Marquis, J. C., Foss, C. A., Nguyen, N., Zimmerman, C. N., Barrett, J. A., Eckelman, W. C., Pomper, M. G., Joyal, J. L., Babich, J. W.
(2009). Preclinical Evaluation of Novel Glutamate-Urea-Lysine Analogues That Target Prostate-Specific Membrane Antigen as Molecular Imaging Pharmaceuticals for Prostate Cancer. Cancer Res.
69: 6932-6940
[Abstract][Full Text]
Cazares, L. H., Troyer, D., Mendrinos, S., Lance, R. A., Nyalwidhe, J. O., Beydoun, H. A., Clements, M. A., Drake, R. R., Semmes, O. J.
(2009). Imaging Mass Spectrometry of a Specific Fragment of Mitogen-Activated Protein Kinase/Extracellular Signal-Regulated Kinase Kinase Kinase 2 Discriminates Cancer from Uninvolved Prostate Tissue. Clin. Cancer Res.
15: 5541-5551
[Abstract][Full Text]
KLEIN, E. A.
(2009). What's new in prostate cancer screening and prevention?. Cleveland Clinic Journal of Medicine
76: 439-445
[Abstract][Full Text]
Canfield, S. E
(2009). Annual screening for prostate cancer did not reduce mortality from prostate cancer. Evid. Based Med.
14: 104-105
[Full Text]
BICKERS, B., AUKIM-HASTIE, C.
(2009). New Molecular Biomarkers for the Prognosis and Management of Prostate Cancer - The Post PSA Era. Anticancer Res
29: 3289-3298
[Abstract][Full Text]
Chisholm, C., Spiekerman, M., Koss, W.
(2009). Undetectable Prostate-Specific Antigen in the Absence of Previous Prostatectomy: Laboratory Error or True Finding?. Lab Med
40: 466-469
[Full Text]
Arneth, B. M.
(2009). Clinical Significance of Measuring Prostate-Specific Antigen. Lab Med
40: 487-491
[Abstract][Full Text]
STEPHAN, C., RITTENHOUSE, H., CAMMANN, H., LEIN, M., SCHRADER, M., DEGER, S., MILLER, K., JUNG, K.
(2009). New Markers and Multivariate Models for Prostate Cancer Detection. Anticancer Res
29: 2589-2600
[Abstract][Full Text]
Brawley, O. W., Ankerst, D. P., Thompson, I. M.
(2009). Screening for Prostate Cancer. CA Cancer J Clin
59: 264-273
[Abstract][Full Text]
Jansen, F. H., Krijgsveld, J., van Rijswijk, A., van den Bemd, G.-J., van den Berg, M. S., van Weerden, W. M., Willemsen, R., Dekker, L. J., Luider, T. M., Jenster, G.
(2009). Exosomal Secretion of Cytoplasmic Prostate Cancer Xenograft-derived Proteins. Mol. Cell. Proteomics
8: 1192-1205
[Abstract][Full Text]
Johansson, M., Van Guelpen, B., Vollset, S. E., Hultdin, J., Bergh, A., Key, T., Midttun, O., Hallmans, G., Ueland, P. M., Stattin, P.
(2009). One-Carbon Metabolism and Prostate Cancer Risk: Prospective Investigation of Seven Circulating B Vitamins and Metabolites. Cancer Epidemiol. Biomarkers Prev.
18: 1538-1543
[Abstract][Full Text]
McFall, S. L., Ureda, J., Byrd, T. L., Valdes, A., Morales, P., Scott, D. B., Williams, D., Calderon-Mora, J., Casillas, M. E., Chan, E. C. Y.
(2009). What is needed for informed decisions about prostate cancer screening: perspectives of African-American and Hispanic men. Health Educ Res
24: 280-291
[Abstract][Full Text]
Maxwell, A., McCudden, C. R., Wians, F., Willis, M. S.
(2009). Recent Advances in the Detection of Prostate Cancer Using Epigenetic Markers in Commonly Collected Laboratory Samples. Lab Med
40: 171-178
[Abstract][Full Text]
Sunami, E., Shinozaki, M., Higano, C. S., Wollman, R., Dorff, T. B., Tucker, S. J., Martinez, S. R., Singer, F. R., Hoon, D. S.B.
(2009). Multimarker Circulating DNA Assay for Assessing Blood of Prostate Cancer Patients. Clin. Chem.
55: 559-567
[Abstract][Full Text]
Shah, G. V., Muralidharan, A., Thomas, S., Gokulgandhi, M., Mudit, M., Khanfar, M., El Sayed, K.
(2009). Identification of a small molecule class to enhance cell-cell adhesion and attenuate prostate tumor growth and metastasis. Molecular Cancer Therapeutics
8: 509-520
[Abstract][Full Text]
Shah, G. V., Muralidharan, A., Gokulgandhi, M., Soan, K., Thomas, S.
(2009). Cadherin Switching and Activation of {beta}-Catenin Signaling Underlie Proinvasive Actions of Calcitonin-Calcitonin Receptor Axis in Prostate Cancer. J. Biol. Chem.
284: 1018-1030
[Abstract][Full Text]
Ishidoya, S., Ito, A., Orikasa, K., Kawamura, S., Tochigi, T., Kuwahara, M., Yamanobe, T., Tomita, Y., Masumori, N., Tsukamoto, T., Shibuya, D., Arai, Y.
(2008). The Outcome of Prostate Cancer Screening in a Normal Japanese Population with PSA of 2-4 ng/ml and the Free/Total PSA Under 12%. Jpn J Clin Oncol
38: 844-848
[Abstract][Full Text]
Sturgeon, C. M., Duffy, M. J., Stenman, U.-H., Lilja, H., Brunner, N., Chan, D. W., Babaian, R., Bast, R. C. Jr., Dowell, B., Esteva, F. J., Haglund, C., Harbeck, N., Hayes, D. F., Holten-Andersen, M., Klee, G. G., Lamerz, R., Looijenga, L. H., Molina, R., Nielsen, H. J., Rittenhouse, H., Semjonow, A., Shih, I.-M., Sibley, P., Soletormos, G., Stephan, C., Sokoll, L., Hoffman, B. R., Diamandis, E. P.
(2008). National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Testicular, Prostate, Colorectal, Breast, and Ovarian Cancers. Clin. Chem.
54: e11-e79
[Abstract][Full Text]
Sardana, G., Dowell, B., Diamandis, E. P.
(2008). Emerging Biomarkers for the Diagnosis and Prognosis of Prostate Cancer. Clin. Chem.
54: 1951-1960
[Abstract][Full Text]
Shiraishi, S., Lee, P. W. N., Leung, A., Goh, V. H. H., Swerdloff, R. S., Wang, C.
(2008). Simultaneous Measurement of Serum Testosterone and Dihydrotestosterone by Liquid Chromatography-Tandem Mass Spectrometry. Clin. Chem.
54: 1855-1863
[Abstract][Full Text]
Parekh, N., Lin, Y., Marcella, S., Kant, A. K., Lu-Yao, G.
(2008). Associations of Lifestyle and Physiologic Factors with Prostate-Specific Antigen Concentrations: Evidence from the National Health and Nutrition Examination Survey (2001-2004). Cancer Epidemiol. Biomarkers Prev.
17: 2467-2472
[Abstract][Full Text]
Cussenot, O., Azzouzi, A.-R., Bantsimba-Malanda, G., Gaffory, C., Mangin, P., Cormier, L., Fournier, G., Valeri, A., Jouffe, L., Roupret, M., Fromont, G., Sibony, M., Comperat, E., Cancel-Tassin, G.
(2008). Effect of Genetic Variability within 8q24 on Aggressiveness Patterns at Diagnosis and Familial Status of Prostate Cancer. Clin. Cancer Res.
14: 5635-5639
[Abstract][Full Text]
U.S. Preventive Services Task Force,
(2008). Screening for Prostate Cancer: U.S. Preventive Services Task Force Recommendation Statement. ANN INTERN MED
149: 185-191
[Abstract][Full Text]
Lucia, M. S., Darke, A. K., Goodman, P. J., La Rosa, F. G., Parnes, H. L., Ford, L. G., Coltman, C. A. Jr., Thompson, I. M.
(2008). Pathologic Characteristics of Cancers Detected in the Prostate Cancer Prevention Trial: Implications for Prostate Cancer Detection and Chemoprevention. Cancer Prevention Research
1: 167-173
[Abstract][Full Text]
Logothetis, C. J., Schellhammer, P. F.
(2008). High-Grade Prostate Cancer and the Prostate Cancer Prevention Trial. Cancer Prevention Research
1: 151-152
[Full Text]
Lilja, H.
(2008). Testing New PSA Subforms to Enhance the Accuracy of Predicting Cancer Risk and Disease Outcome in Prostate Cancer. Clin. Chem.
54: 1248-1249
[Full Text]
Leeming, D. J., Hegele, A., Byrjalsen, I., Hofmann, R., Qvist, P., Karsdal, M. A., Schrader, A. J., Wagner, R., Olbert, P.
(2008). Biochemical Markers for Monitoring Response to Therapy: Evidence for Higher Bone Specificity by a Novel Marker Compared with Routine Markers. Cancer Epidemiol. Biomarkers Prev.
17: 1269-1276
[Abstract][Full Text]
Eekers, D. B. P., Laschet, A., de Groot, M., Roelofs, E., Kester, A., Delaere, K., Lambin, P., van Gils, F., Nap, M., ten Kate, J.
(2008). Why determine only the total prostate-specific antigen, if the free-to-total ratio contains the information?. Ann Clin Biochem
45: 270-274
[Abstract][Full Text]
Vener, T., Derecho, C., Baden, J., Wang, H., Rajpurohit, Y., Skelton, J., Mehrotra, J., Varde, S., Chowdary, D., Stallings, W., Leibovich, B., Robin, H., Pelzer, A., Schafer, G., Auprich, M., Mannweiler, S., Amersdorfer, P., Mazumder, A.
(2008). Development of a Multiplexed Urine Assay for Prostate Cancer Diagnosis. Clin. Chem.
54: 874-882
[Abstract][Full Text]
Kelly, K. A., Setlur, S. R., Ross, R., Anbazhagan, R., Waterman, P., Rubin, M. A., Weissleder, R.
(2008). Detection of Early Prostate Cancer Using a Hepsin-Targeted Imaging Agent. Cancer Res.
68: 2286-2291
[Abstract][Full Text]
Loeb, S., Catalona, W. J.
(2008). What to Do with an Abnormal PSA Test. The Oncologist
13: 299-305
[Abstract][Full Text]
Crawford, E. D.
(2008). Response. JNCI J Natl Cancer Inst
100: 223-224
[Full Text]
Laxman, B., Morris, D. S., Yu, J., Siddiqui, J., Cao, J., Mehra, R., Lonigro, R. J., Tsodikov, A., Wei, J. T., Tomlins, S. A., Chinnaiyan, A. M.
(2008). A First-Generation Multiplex Biomarker Analysis of Urine for the Early Detection of Prostate Cancer. Cancer Res.
68: 645-649
[Abstract][Full Text]
Connolly, D., Black, A., Gavin, A., Keane, P. F., Murray, L. J.
(2008). Baseline Prostate-Specific Antigen Level and Risk of Prostate Cancer and Prostate-Specific Mortality: Diagnosis Is Dependent on the Intensity of Investigation. Cancer Epidemiol. Biomarkers Prev.
17: 271-278
[Abstract][Full Text]
McLerran, D., Grizzle, W. E., Feng, Z., Bigbee, W. L., Banez, L. L., Cazares, L. H., Chan, D. W., Diaz, J., Izbicka, E., Kagan, J., Malehorn, D. E., Malik, G., Oelschlager, D., Partin, A., Randolph, T., Rosenzweig, N., Srivastava, S., Srivastava, S., Thompson, I. M., Thornquist, M., Troyer, D., Yasui, Y., Zhang, Z., Zhu, L., Semmes, O. J.
(2008). Analytical Validation of Serum Proteomic Profiling for Diagnosis of Prostate Cancer: Sources of Sample Bias. Clin. Chem.
54: 44-52
[Abstract][Full Text]
McLerran, D., Grizzle, W. E., Feng, Z., Thompson, I. M., Bigbee, W. L., Cazares, L. H., Chan, D. W., Dahlgren, J., Diaz, J., Kagan, J., Lin, D. W., Malik, G., Oelschlager, D., Partin, A., Randolph, T. W., Sokoll, L., Srivastava, S., Srivastava, S., Thornquist, M., Troyer, D., Wright, G. L., Zhang, Z., Zhu, L., Semmes, O. J.
(2008). SELDI-TOF MS Whole Serum Proteomic Profiling with IMAC Surface Does Not Reliably Detect Prostate Cancer. Clin. Chem.
54: 53-60
[Abstract][Full Text]
Lane, J A., Howson, J., Donovan, J. L, Goepel, J. R, Dedman, D. J, Down, L., Turner, E. L, Neal, D. E, Hamdy, F. C
(2007). Detection of prostate cancer in unselected young men: prospective cohort nested within a randomised controlled trial. BMJ
335: 1139-1139
[Abstract][Full Text]
Shim, H. B., Lee, S. E., Park, H. K., Ku, J. H.
(2007). Histological Diagnosis of Prostate Cancer in Korean Men Aged 70 79 Years. Jpn J Clin Oncol
0: hym093v1-6
[Abstract][Full Text]
Parekh, D. J., Ankerst, D. P., Baillargeon, J., Higgins, B., Platz, E. A., Troyer, D., Hernandez, J., Leach, R. J., Lokshin, A., Thompson, I. M.
(2007). Assessment of 54 Biomarkers for Biopsy-Detectable Prostate Cancer. Cancer Epidemiol. Biomarkers Prev.
16: 1966-1972
[Abstract][Full Text]
Kundra, V., Silverman, P. M., Matin, S. F., Choi, H.
(2007). Imaging in Oncology from The University of Texas M. D. Anderson Cancer Center: Diagnosis, Staging, and Surveillance of Prostate Cancer. Am. J. Roentgenol.
189: 830-844
[Abstract][Full Text]
Nam, R. K., Toi, A., Klotz, L. H., Trachtenberg, J., Jewett, M. A.S., Appu, S., Loblaw, D. A., Sugar, L., Narod, S. A., Kattan, M. W.
(2007). Assessing Individual Risk for Prostate Cancer. JCO
25: 3582-3588
[Abstract][Full Text]
Thompson, I. M., Pauler Ankerst, D., Chi, C., Goodman, P. J., Tangen, C. M., Lippman, S. M., Lucia, M. S., Parnes, H. L., Coltman, C. A. Jr
(2007). Prediction of Prostate Cancer for Patients Receiving Finasteride: Results From the Prostate Cancer Prevention Trial. JCO
25: 3076-3081
[Abstract][Full Text]
Kerfoot, B. P., Holmberg, E. F., Lawler, E. V., Krupat, E., Conlin, P. R.
(2007). Practitioner-Level Determinants of Inappropriate Prostate-Specific Antigen Screening. Arch Intern Med
167: 1367-1372
[Abstract][Full Text]
Fradet, Y.
(2007). Rebuttal: Should Canadians be offered systematic prostate cancer screening?: YES. cfp
53: 1140-1141
[Full Text]
Fradet, Y.
(2007). Refutation: Devrait-on offrir aux Canadiens le depistage systematique du cancer de la prostate?: OUI. cfp
53: 1142-1143
[Full Text]
Jewett, M. A.S., Klotz, L. H., for the University of Toronto Uro-Oncology Program,
(2007). Advances in the medical management of benign prostatic hyperplasia. CMAJ
176: 1850-1851
[Full Text]
Freedland, S. J., Platz, E. A.
(2007). Obesity and Prostate Cancer: Making Sense out of Apparently Conflicting Data. Epidemiol Rev
0: mxm006v1-
[Abstract][Full Text]
Martin, R. M
(2007). Commentary: Prostate cancer is omnipresent, but should we screen for it?. Int J Epidemiol
36: 278-281
[Full Text]
Albertsen, P. C
(2007). Commentary: Occult prostate cancer--imposter or the real deal?. Int J Epidemiol
36: 281-282
[Full Text]
Gross, M., Top, I., Laux, I., Katz, J., Curran, J., Tindell, C., Agus, D.
(2007). {beta}-2-Microglobulin Is an Androgen-Regulated Secreted Protein Elevated in Serum of Patients with Advanced Prostate Cancer. Clin. Cancer Res.
13: 1979-1986
[Abstract][Full Text]
Etzioni, R. D., Ankerst, D. P., Thompson, I. M.
(2007). Re: Detection of Life-Threatening Prostate Cancer With Prostate-Specific Antigen Velocity During a Window of Curability. JNCI J Natl Cancer Inst
99: 489-490
[Full Text]
Krist, A. H., Woolf, S. H., Johnson, R. E., Kerns, J. W.
(2007). Patient Education on Prostate Cancer Screening and Involvement in Decision Making. Ann Fam Med
5: 112-119
[Abstract][Full Text]
Bai, V. U., Kaseb, A., Tejwani, S., Divine, G. W., Barrack, E. R., Menon, M., Pardee, A. B., Reddy, G. P.-V.
(2007). Identification of prostate cancer mRNA markers by averaged differential expression and their detection in biopsies, blood, and urine. Proc. Natl. Acad. Sci. USA
104: 2343-2348
[Abstract][Full Text]
Lilja, H., Ulmert, D., Bjork, T., Becker, C., Serio, A. M., Nilsson, J.-A., Abrahamsson, P.-A., Vickers, A. J., Berglund, G.
(2007). Long-Term Prediction of Prostate Cancer Up to 25 Years Before Diagnosis of Prostate Cancer Using Prostate Kallikreins Measured at Age 44 to 50 Years. JCO
25: 431-436
[Abstract][Full Text]
Werny, D. M., Thompson, T., Saraiya, M., Freedman, D., Kottiri, B. J., German, R. R., Wener, M.
(2007). Obesity Is Negatively Associated with Prostate-Specific Antigen in U.S. Men, 2001-2004. Cancer Epidemiol. Biomarkers Prev.
16: 70-76
[Abstract][Full Text]
Wilt, T. J, Thompson, I. M
(2006). Clinically localised prostate cancer. BMJ
333: 1102-1106
[Full Text]
Thompson, I. M.
(2006). PSA: A Biomarker for Disease. A Biomarker for Clinical Trials. How Useful Is It?. J. Nutr.
136: 2704S-2704S
[Full Text]
Thomas, S., Chigurupati, S., Anbalagan, M., Shah, G.
(2006). Calcitonin Increases Tumorigenicity of Prostate Cancer Cells: Evidence for the Role of Protein Kinase A and Urokinase-Type Plasminogen Receptor. Mol. Endocrinol.
20: 1894-1911
[Abstract][Full Text]
Lee, S. E., Byun, S.-S., Park, H. K., Shim, H. B., Ku, J. H.
(2006). Detection of Prostate Cancer at Low and Intermediate Serum Prostate-Specific Antigen Levels in a Country with a Low Incidence of Prostate Cancer. Jpn J Clin Oncol
36: 376-380
[Abstract][Full Text]
Groskopf, J., Aubin, S. M.J., Deras, I. L., Blase, A., Bodrug, S., Clark, C., Brentano, S., Mathis, J., Pham, J., Meyer, T., Cass, M., Hodge, P., Macairan, M. L., Marks, L. S., Rittenhouse, H.
(2006). APTIMA PCA3 Molecular Urine Test: Development of a Method to Aid in the Diagnosis of Prostate Cancer. Clin. Chem.
52: 1089-1095
[Abstract][Full Text]
Hamashima, C., Sobue, T., Muramatsu, Y., Saito, H., Moriyama, N., Kakizoe, T.
(2006). Comparison of Observed and Expected Numbers of Detected Cancers in the Research Center for Cancer Prevention and Screening Program. Jpn J Clin Oncol
36: 301-308
[Abstract][Full Text]
Carter, H. B.
(2006). Assessing risk: does this patient have prostate cancer?. JNCI J Natl Cancer Inst
98: 506-507
[Full Text]
Thompson, I. M., Ankerst, D. P., Chi, C., Goodman, P. J., Tangen, C. M., Lucia, M. S., Feng, Z., Parnes, H. L., Coltman, C. A. Jr.
(2006). Assessing prostate cancer risk: results from the Prostate Cancer Prevention Trial.. JNCI J Natl Cancer Inst
98: 529-534
[Abstract][Full Text]
Hoffman, R. M.
(2006). Viewpoint: limiting prostate cancer screening.. ANN INTERN MED
144: 438-440
[Abstract][Full Text]
Catalona, W. J., Loeb, S., Han, M.
(2006). Viewpoint: expanding prostate cancer screening.. ANN INTERN MED
144: 441-443
[Abstract][Full Text]
Lippman, S. M., Lee, J. J.
(2006). Reducing the "Risk" of Chemoprevention: Defining and Targeting High Risk--2005 AACR Cancer Research and Prevention Foundation Award Lecture.. Cancer Res.
66: 2893-2903
[Abstract][Full Text]
Tan, E.M., Koziol, J. A., Kida, Y., Thorat, M. A., Badwe, R. A., Rocco, B., Djavan, B., de Cobelli, O., Wang, X., Ghosh, D., Chinnaiyan, A. M.
(2005). Autoantibodies in prostate cancer.. NEJM
353: 2815-2817
[Full Text]
Yeh, A. H., Jeffery, P. L., Duncan, R. P., Herington, A. C., Chopin, L. K.
(2005). Ghrelin and a Novel Preproghrelin Isoform Are Highly Expressed in Prostate Cancer and Ghrelin Activates Mitogen-Activated Protein Kinase in Prostate Cancer. Clin. Cancer Res.
11: 8295-8303
[Abstract][Full Text]
Thompson, I. M., Tangen, C. M., Klein, E. A., Lippman, S. M.
(2005). Phase III Prostate Cancer Prevention Trials: Are the Costs Justified?. JCO
23: 8161-8164
[Abstract][Full Text]
Klotz, L.
(2005). Active Surveillance for Prostate Cancer: For Whom?. JCO
23: 8165-8169
[Abstract][Full Text]
Klein, E. A., Tangen, C. M., Goodman, P. J., Lippman, S. M., Thompson, I. M.
(2005). Assessing Benefit and Risk in the Prevention of Prostate Cancer: The Prostate Cancer Prevention Trial Revisited. JCO
23: 7460-7466
[Abstract][Full Text]
Wang, X., Yu, J., Sreekumar, A., Varambally, S., Shen, R., Giacherio, D., Mehra, R., Montie, J. E., Pienta, K. J., Sanda, M. G., Kantoff, P. W., Rubin, M. A., Wei, J. T., Ghosh, D., Chinnaiyan, A. M.
(2005). Autoantibody Signatures in Prostate Cancer. NEJM
353: 1224-1235
[Abstract][Full Text]
Albertsen, P. C., Hanley, J. A., Fine, J.
(2005). Localized Prostate Cancer and DNA Ploidy--Reply. JAMA
294: 1207-1208
[Full Text]
Thompson, I. M., Canby-Hagino, E., Lucia, M. S.
(2005). Stage Migration and Grade Inflation in Prostate Cancer: Will Rogers Meets Garrison Keillor. JNCI J Natl Cancer Inst
97: 1236-1237
[Full Text]
Saraiya, M., Kottiri, B. J., Leadbetter, S., Blackman, D., Thompson, T., McKenna, M. T., Stallings, F. L.
(2005). Total and Percent Free Prostate-Specific Antigen Levels among U.S. Men, 2001-2002. Cancer Epidemiol. Biomarkers Prev.
14: 2178-2182
[Abstract][Full Text]
Parsons, J. K., Carter, H. B., Platz, E. A., Wright, E. J., Landis, P., Metter, E. J.
(2005). Serum Testosterone and the Risk of Prostate Cancer: Potential Implications for Testosterone Therapy. Cancer Epidemiol. Biomarkers Prev.
14: 2257-2260
[Abstract][Full Text]
Welch, H. G., Schwartz, L. M., Woloshin, S.
(2005). Prostate-Specific Antigen Levels in the United States: Implications of Various Definitions for Abnormal. JNCI J Natl Cancer Inst
97: 1132-1137
[Abstract][Full Text]
Sheffield, J. V.L., Larson, E. B.
(2005). Update in General Internal Medicine. ANN INTERN MED
143: 212-221
[Full Text]
Kristal, A. R., Schenk, J. M.
(2005). Directions for Future Epidemiological Research in Lycopene and Prostate Cancer Risk. J. Nutr.
135: 2037S-2039S
[Full Text]
Sharifi, N., Gulley, J. L., Dahut, W. L.
(2005). Androgen Deprivation Therapy for Prostate Cancer. JAMA
294: 238-244
[Abstract][Full Text]
Thompson, I. M., Ankerst, D. P., Chi, C., Lucia, M. S., Goodman, P. J., Crowley, J. J., Parnes, H. L., Coltman, C. A. Jr
(2005). Operating Characteristics of Prostate-Specific Antigen in Men With an Initial PSA Level of 3.0 ng/mL or Lower. JAMA
294: 66-70
[Abstract][Full Text]
Talcott, J. A.
(2005). Employment After Therapy for Localized Prostate Cancer: Widening the Perspective. JNCI J Natl Cancer Inst
97: 948-949
[Full Text]
Bastian, P. J., Ellinger, J., Wellmann, A., Wernert, N., Heukamp, L. C., Muller, S. C., von Ruecker, A.
(2005). Diagnostic and Prognostic Information in Prostate Cancer with the Help of a Small Set of Hypermethylated Gene Loci. Clin. Cancer Res.
11: 4097-4106
[Abstract][Full Text]
Paul, B., Dhir, R., Landsittel, D., Hitchens, M. R., Getzenberg, R. H.
(2005). Detection of Prostate Cancer with a Blood-Based Assay for Early Prostate Cancer Antigen. Cancer Res.
65: 4097-4100
[Abstract][Full Text]
A correction has been published: N Engl J Med 2004;351(14):1470.
4.0 ng per Milliliter
Previous
