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Sakai N.,Yokosuka Kyosai Hospital | Taguri M.,Yokohama City University | Kobayashi K.,Yokosuka Kyosai Hospital | Noguchi S.,Yokosuka Kyosai Hospital | And 4 more authors.
International Journal of Urology | Year: 2015

Objectives: To investigate whether prostate-specific antigen-based screening reduced the prostate cancer mortality rate in Yokosuka, Japan. Methods: We carried out a cohort study, in which we compared clinical outcomes between patients detected by prostate-specific antigen-based screening (S group n=524) versus those detected by other means (NS group n=1044). Clinical and pathological factors were evaluated using Cox regression analyses and the Kaplan-Meier method. Results: A total of 1.5% (8/524) of patients in the S group and 6.7% (70/1044) of those in the NS group died from prostate cancer during follow up. A total of 8.0% (42/524) of patients in the S group and 11.4% (119/1044) in the NS group died from other causes. The 10-year cancer specific survival rates of the S and NS groups were 97% and 86%, respectively (P<0.001). The median age was significantly lower in the S group than the NS group: 71 and 73years, respectively (P<0.001). The rate of Gleason score 8-10 was significantly lower in the S group than the NS group: 9.7% and 16.7%, respectively (P<0.001). The rate of patients with metastasis or prostate-specific antigen 100ng/mL or more was significantly lower in the S group than the NS group: 7.8% and 23.0%, respectively (P<0.001). On multivariate analysis, Gleason score 8-10 compared with Gleason score 6 was independently associated with cancer-specific survival (hazard ratio 4.808, 95% confidence interval 1.044-22.14, P=0.044). Conclusions: Prostate-specific antigen-based population screening in Yokosuka City might help to reduce the prostate cancer mortality rate. © 2015 The Japanese Urological Association.

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