Clinical outcomes of prostate cancer patients detected by prostate-specific antigen-based population screening in Kanazawa City, Japan

Abstract

Most common population screening systems for prostate cancer are administered by municipal governments in Japan. These systems suffer from difficulties in adequate follow up of patients at several urology departments in the region. We analyzed the clinical characteristics and outcomes of prostate cancer patients detected in our prostate-specific antigen (PSA)-based population screen, and examined the efficiency of the system. Since 2000, we have carried out PSA-based population screening in men aged 55-69 years. For the present study, primary treatments and clinical outcomes of prostate cancer patients diagnosed by this screening program were obtained from each urology department in the region. A total of 32,769 men participated in this screening program from 2000 to 2006. Overall, 249 cases (0.76%) of prostate cancer were diagnosed. The rate of patients within gray zone levels of serum total PSA on primary screening increased and this was significantly higher in 2003 than in the first 2 years of the program. Clinical T stage was defined in 247 patients (99.2%), and 231 (93.5%) were cases of clinically localized cancer. A total of 75% of these patients underwent radical treatment. Eight-year cause-specific and overall survivals were 97.5% and 93.3%, respectively. Four patients, all of them presenting with advanced disease at diagnosis, died from prostate cancer. The present study showed good clinical outcomes for screening-detected prostate cancer patients and it showed the effectiveness of our screening system.