Independent “Blue Ribbon” Expert Panel: Consensus-Based Educational Information About Prostate Cancer Screening

Formed in 2015 and consisting of the key experts in prostate cancer clinical care and research, the Panel serves as a working advisory board and represents the state’s leading academic and clinical institutions. The Panel provides guidance on the most recent advances in patient care for the education and awareness campaign. In March 2016, the Panel developed consensus-based educational information about screening and related options with specific focus on men at high risk of life-threatening (aggressive) prostate cancer.

Prostate Cancer Action Council
Panel Members
About Prostate Cancer Screening
Press Release

Informed Decision Making – Multi-Center Consensus Recommendations

  • Vickers AJ, Edwards K, Cooperberg MR et al (2014) A simple schema for Informed decision making about prostate cancer screening, Ann Intern Medical, Vol. 161 pp. 441 (online) available from <http://annals.org/article.aspx?articleid=1905132>

 

  • Vickers AJ, Eastham JA, Scardino PT, Lilja H. The Memorial Sloan Kettering Cancer Center Recommendations for Prostate Cancer Screening. Urology. 2016 Feb 2. [Epub ahead of print]

 

  • Carlsson, S, Lilja, H, Vickers, A. Clinical Consultation Guide: How to Optimize Prostate Specific Antigen in the Current Era. European Urology Focus 2015: 149-151.

http://www.europeanurology.com/article/S2405-4569%2815%2900032-2/pdf/clinical-consultation-guide-how-to-optimize-the-use-of-prostate-specific-antigen-in-the-current-era

 

Selected Original Trials & Data/Risks and Benefits of Screening

 

  • Andriole, G., Crawford, D., Grubb, R., Buys, S., Chia, D. & Church, T. Mortality Results from a Randomizing Prostate Cancer Screening Trial, The New England Journal of Medicine 2009, Vol. 360, Issue. 13, pp. 1310 – 1319 (online) availabble from <http://www.nejm.org/doi/pdf/10.1056/NEJMoa0810696>

 

  • Over-treatment of low risk and under-treatment of high risk prostate cancer: Cooperberg MR, Broering JM, Carroll PR.(2010) Time trends and local variation in primary treatment of localized prostate cancer, Journal of Clinical Oncology, Vol. 28, pp. 1117-1123. (Online) available from <http://jco.ascopubs.org/content/28/7/1117.full>

 

  • Over-screening in older men:Drazer MW, Huo D, Schonberg MA, et al. (2011) Population-based patterns and predictors of PSA screening among older men in the United States, Journal of Clinical Oncology, Vol. 29, pp. 1736-1743. (online) available from <http://jco.ascopubs.org/content/29/13/1736.full.pdf+html>

 

  • Eggener, SE., Scardino, PT., Walsh, PC., Han, M., Partin, AW., Trock, BJ., Feng, Z., Wood, DP., Eastham, JA., Yossepowitch, O., Kattan, MW., Yu, C., Klein, EA. & Stephenson, AJ. (2011) Predicting 15-year prostate cancer mortality after radical prostatectomy, Journal of Urology, Vol. 185, Issue. 3, pp. 869-75 (online) available from <http://www.ncbi.nlm.nih.gov/pubmed/21239008>

 

  • Etzioni, R., Cooperberg, M., Penson, D., Weiss, N. & Thompson, I. (2013) Limitations of basing screening policies on screening trials: The US Preventive Services Task Force and Prostate Cancer Screening, National Institutes of Health, Vol. 54 Issue 4, pp. 295 – 300 (online) available from <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3604989/>

 

  • Etzioni R, Penson D, Legler J, di Tommasao D, Boer R, Gann P, et al. Overdiagnosis due to prostate-specific antigen screening: lessons from U.S. prostate cancer incidence trends. J Natl Cancer Inst 2002;94: 981-90. http://jnci.oxfordjournals.org/content/94/13/981

 

  • Modeling-Based Prediction of a 13-20% increase in mortality with discontinued PSA screening: Gulati R, Gore JL, Etzioni R. Comparative effectiveness of alternative prostate-specific antigen–based prostate cancer screening strategies: model estimates of potential benefits and harms.Ann Intern Med. 2013;158(3):145-153

 

  • Jemal, A., Fedewa, S., Ma, J., Siegel, R., Chieh, C., Brawley, O. & ward, E. (2015) Prostate Cancer Incidence and PSA Testing Patterns in Relation to USPSTF Screening Recommendations, JAMA, Vol. 314, Issue. 19, pp. 2054-2061. (online) available from <http://jama.jamanetwork.com/article.aspx?articleid=2470446>

 

 

  • Nam RK, Saskin R, Lee Y, Liu Y, Law C, Klotz LH, Loblaw DA, Trachtenberg J, Stanimirovic A, Simor AE, Seth A, Urbach DR, Narod SA (2010) Increasing hospital admission rates for urological complications after trans rectal ultrasound guided prostate biopsy, Journal of Urology, Vol. 183, pp. 963-968. (online) available from <http://www.jurology.com/article/S0022-5347(09)02932-2/abstract>

 

 

 

  • Sammon, J., Abdollah, F., Choueiri, T., Kantoff, P., Nguyen, P., Menon, M. & Trinh, QD. (2015) Prostate-Specific Antigen Screening After 2012 US Preventive Services Task Force Recommendations, JAMA, Vol. 314, Issue. 19, pp. 2077-2079. (online) available from <http://jama.jamanetwork.com/article.aspx?articleid=2470435>

 

  • Schroder, F., Hugosson, J., Roobol, M., Tammela, T., Ciatto, S. &Nelen, V. (2009) Screening and Prostate Cancer Mortality in Randomized European Study, The New England Journal of Medicine, Vol. 360, pp. 1320-1328 (online) available from <http://www.nejm.org/doi/full/10.1056/NEJMoa0810084>

 

 

 

 

Baseline PSA at younger age/mid-life decreases over-diagnosis and increases ratio of the number of men screened (NNS) to treated (NNT) to one life saved

 

 

  • Improved mortality benefit of treatment of high risk disease over >20 years of observation – and reduction of NNT to one life saved (8:1) with improved risk stratification (based on age and tumor risk).Bill-Axelson, A. et al. (2011) for the SPCG-4 Investigators. Radical Prostatectomy versus Watchful Waiting in Early Prostate Cancer. New England Journal of Medicine, Vol. 364, pp. 1708-1717. (online) available from <http://www.nejm.org/doi/full/10.1056/NEJMoa1011967?viewType=Print>

 

 

  • Modeling Quality if Life Study Demonstrating 98 NNS to 5 NNT to one life saved (Based on European Trial). Heijnsdijk, E., Wever, E., Auvinen, A., Hugosson, J., Ciatto, S., Nelen, V., Kwiatkowski, M., Villers, A., Paez, A., Moss, S., Zappa, M., Tammela, T., Makinen, T., Carlsson, S., Korfoge, I., Essink – Bot, M., Otta, S., Draisma, G., Bangma C., Roobol, M., Schroder, F. & Koning, H. (2012) Quality of Life Effects of Prostate Specific Antigen Screening, The New England Journal of Medicine, Vol. 367, No. 7, pp. 595 – 605. (online) available from <http://www.nejm.org/doi/pdf/10.1056/NEJMoa1201637>

 

  • Larsen, S., Brasso, K., Iversin, P., Christensen, J., Christensen, M., Carlsson, S., Lilja, H., Friis, S., Tjonneland, A. and Dalton, S. (2014) Baseline PSA measurements and subsequent prostate cancer risk in the Danish Diet, Cancer and Health cohort, European Journal of Cancer, Vol. 49, Issue 14, pp. 3041 – 3048. (online) available from <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4074899/>

 

 

  • Preston, M., Batisa, J., Carlsson, S., Gerke, t., Dahl, D., Feldman, A., Gann, P., Vickers, A. &Stampfer, M. (2014) MP69-06 Prostate specific antigen (PSA) levels in men <60 years of age predicts lethal prostate cancer, The Journal of Urology, Vol. 191, Issue. 4, pp.816 (online) available from <http://www.jurology.com/article/S0022-5347(14)02484-7/fulltext>

 

 

  • Vickers A, Cronin A, Björk T, Manjer J, Dahlin A, Bjartell A, Scardino P, Ulmert D and Lilja H. (2010) Probability of eventually developing or dying of prostate cancer by PSA at age 60 Mid-life PSA levels strongly predict long-term risk of prostate cancer morbidity, BMJ; 341:c4521 (online) available from <http://www.bmj.com/content/341/bmj.c4521.abstract>

 

 

Discussion of this article:http://prostatecancerinfolink.net/2015/04/10/correlating-baseline-psa-levels-to-future-10-year-risk-of-prostate-cancer-diagnosis/

 

 

 

  • Vickers, A., Sjoberg, D., Ulmert, D., Vertosick, E., Roobol, M., Thompson, I., Heijnsdijk, E., De Koning, H.,Atoria – Swartz, C., Scardino, P. & Lilja, H. (2014) Empirical estimates of prostate cancer over diagnosis by age and prostate – specific antigen, Medicine, pp. 12-26. (online) available from <http://www.biomedcentral.com/1741-7015/12/26>

 

  • Vickers, A., Ulmert, D., Sjoberg, D., Bennette, C., Bjork, T., Gerdtsson, A., Manjer, J., Nillsson, P., Dahlin, A., Bjartell, A., Scardino, P. & Lilja, H. (2013) Strategy for detection of prostate cancer based on relation between prostate specific antigen at age 40-55 and long term risk of metastasis, BMJ, (online) available from <http://www.bmj.com/content/346/bmj.f2023>

 

  • Weight, C., Kim, S., Jacobson, D., McGree, M., Karnes, R.J. and St. Sauver, J. (2013) Men (Aged 40 – 49 Years) With a Single Baseline Prostate specific Antigen Below 1.0 ng/mL Have a Very Low Long term Risk of Prostate Cancer: Results From a Prospective Screened Population Cohort, Journal of Urology, Vol. 82, Issue 6, pp. 1211 – 1219 (online) available from <http://www.goldjournal.net/article/S0090-4295(13)01061-3/abstract>

 

Cost-Effective PSA Modifications to Improve Specificity and Reduce Unnecessary Biopsy

 

  • Gupta A, Roobol MJ, Savage CJ, Peltola M, Pettersson K, Scardino PT, Vickers AJ, Schröder FH, Lilja H. A four-kallikrein panel for the prediction of repeat prostate biopsy: data from the European Randomized Study of Prostate Cancer screening in Rotterdam, Netherlands.Br J Cancer. 2010;103:708-14 (online) available from <http://www.ncbi.nlm.nih.gov/pubmed/20664589>

 

  • Stattin, P., Vickers, A., Sjoberg, D., Johansson, R., Granfors, T., Johansson, M., Pettersson, K., Scardino, P., Hallmans, G. & Lilja, H. (2015) Improving the specificity of screening for lethal prostate cancer using prostate specific antigen and a panel of killikrein markers: a nested case control study, European Urology, Vol. 6051, pp. 214 -215. (online) available from <http://www.sciencedirect.com/science/article/pii/S030228381500024X>

 

  • William J. Catalona, Alan W. Partin, Martin G. Sanda, John T. Wei, George G. Klee, Chris H. Bangma, Kevin M. Slawin, Leonard S. Marks, Stacy Loeb, Dennis L. Broyles, Sanghyuk S. Shin, Amabelle B. Cruz, Daniel W. Chan, Lori J. Sokoll, William L. Roberts, Ron H.N. van Schaik, Isaac A. Mizrahi (2011) A Multicenter Study of [-2]Pro-Prostate Specific Antigen Combined With Prostate Specific Antigen and Free Prostate Specific Antigen for Prostate Cancer Detection in the 2.0 to 10.0 ng/ml Prostate Specific Antigen Range, Journal of Urology,, Vol. 185 pp.1650-1655. (online) available from <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140702/.>

 

Increase in the Utillization of Active Surveillance and Decrease in Over-Treatment of Low Risk Prosttae Cancer in Recent Years

 

  • Klotz, L., Zhang, L., Lam, A., Nam, R., Mamedov, , & Loblaw, A. (2010) Clinical Results of Long Term Follow Up of a large, Active Surveillance Cohort With Localized Prostate Cancer, Journal of Clinical Oncology, Vol.28, No.1, pp. 126 -131. (online) available from <http://jco.ascopubs.org/content/28/1/126.full.pdf+html>

 

 

 

 

Health Disparities

 

  • Azier, A., Wilhite, T., Chen, M., Graham, P., Choueiri, T., Hoffman, K., Martin, N., Trinh, Q., Hu, J. and Nguyen (2014) Lack of Reduction in Racial Disparities in Cancer Specific Mortality Over a 20 Year Period, Cancer, Vol. 120, Issue 10, pp.1532-1539 (online) available from <http://www.ncbi.nlm.nih.gov/pubmed/24863392>

 

  • Evans, S. et. al. Clinical presentation and initial management of black men and white men with prostate cancer in the United Kingdom: the PROCESS cohort study. Br. J. Cancer 102: 249-254 (2010). Results: “Supporting the concept that screening and access would minimize the racial disparity in prostate cancer, no difference in disease characteristics at the time of diagnosis were identified in black men in the Prostate Conditions in Ethnic Subgroups cohort based in southern England, where free medical care is available to all. “ (Quote: from the McKinley, , et al below)

 

  • Moul JW, Sesterhenn IA, Connelly RR, et. al. Prostate-specific antigen values at the time of prostate cancer diagnosis in African-American men. 1995 Oct 25;274(16):1277-81.

http://jama.jamanetwork.com/article.aspx?articleid=389871

 

  • Mahal, B., Aizer, A., Ziehr, D., Hyatt, A., Choueiri, T., Hu, J., Hoffman, K., Sweeney, C., Beard, C., D’Amico, C., Martin, N., Kim, S., Trinh, Q. & Nguyen, P. (2014) Racial Disparities in Prostate Cancer – Specific Mortality in men with Low Risk Prostate Cancer, Clinical Genitourinary Cancer, Vol. 12, No. 5, pp. 189 – 195. (Online) available from <http://www.ncbi.nlm.nih.gov/pubmed/24861952>

 

  • Mahal, B., Aizer, A., Ziehr, D., Hyatt, A., Sammon, J., Schmid, M., Choueiri, T., Hu, J., Sweeney, c., Beard, C., D’Amico, A., Martin, N., Kim, S., Trinh, Q. & Nguyen, P. (2014) Trends in disparate treatment of African American men with localized prostate cancer across national comprehensive cancer network risk groups, Urology, Vol. 84 Issue 2, pp.386 -392 (Online) available from <http://www.ncbi.nlm.nih.gov/pubmed/24975710>

 

 

  • Moul, JW. Prostate Cancer Active Surveillance in African American Men. Nature Reviews in Urology 2013 (10): 311-312. Quote: “In my opinion, a baseline PSA test is especially important for African American men because they have a tendency to develop prostate cancer at a younger age than white men and might have more to lose if the disease is not detected in an early, curable state. That is, in the PSA era, the ‘racial gap’ was narrowed; if we abandon screening now, we will see more African American men die of prostate cancer.”

Online: http://www.nature.com/nrurol/journal/v10/n6/full/nrurol.2013.97.html

 

  • Powell, I., Bock, C., Ruterbusch, J. &Sakr, W. (2010) Evidence Supports a Faster Growth rate and/ or Earlier Transformation to Clinically Significant Prostate Cancer in Black Than in White American Men and Influences Racial Progression and Mortality Disparity, National Institute of Health, Vol. 183 Issues 5, pp. 1792 -1796(online) available from <http://www.ncbi.nlm.nih.gov/pubmed/20299055>

 

 

  • Schmid, M., Meyer, C., Reznor, G., Choueiri, T., Hanske, J., Sammon, J., Abdollah, F., Chun, F., Kibel, A., Tucker – Seeley, R., Kantoff, P., Lipsitz, S., Memon, M., Nguyen, P. Trinh, Q. (2015)Racial differences in the surgical care of medicare beneficiaries with localized prostate cancer, JAMA Oncology available from <http://oncology.jamanetwork.com/article.aspx?articleid=2463623> pp. 3384

 

  • Sundi D, Ross AE, Humphreys EB, Han,M, Partin AW, Carter HB, Schaeffer HE (2013).African American Men With Very Low–Risk Prostate Cancer Exhibit Adverse Oncologic Outcomes After Radical Prostatectomy: Should Active Surveillance Still Be an Option for Them?Journal of Clinical Oncology, Vol 31, No 24 (August 20), 2013: pp. 2991-2997. Available from http://www.ncbi.nlm.nih.gov/pubmed/23775960

 

 

 

Data on the Impact of US PSTF Recommendations on Delayed Diagnosis of High Risk Prostate Cancer in over 23% of men.

 

  • Barocas, D., Mallin, K., Graves, A., Penson, D., Palis, B., Winchester, D. & Chang, S. (2015) Effect of the USPSTF Grade D Recommendation against Screening for Prostate Cancer on Incident Prostate Cancer Diagnoses in the United States, Journal of Urology 2015, Vol. 194 pp. 1587-1593 (online) available from <http://www.jurology.com/article/S0022-5347%2815%2904209-3/pdf>