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- Title
Optimal Starting Age and Baseline Level for Repeat Tests: Economic Concerns of PSA Screening for Chinese Men – 10-Year Experience of a Single Center.
- Authors
Liu, Yang; Xiao, Gang; Zhou, Jia-Wei; Yang, Jian-Kun; Lu, Li; Bian, Jun; Zhong, Lin; Wei, Qing-Zhu; Zhou, Qi-Zhao; Xue, Kang-Yi; Guo, Wen-Bing; Xia, Ming; Zhou, Jun-Hao; Bao, Ji-Ming; Yang, Cheng; Liu, Cun-Dong; Chen, Ming-Kun
- Abstract
Objective: To investigate the optimal age for the baseline serum prostate-specific antigen (PSA) test and for repeat screening and its economic burden in a single center in China. Materials and Methods: 35,533 men with PSA screening were retrospectively enrolled in this study. Follow-ups were conducted in 1,586 men with PSA >4 ng/mL, and receiver-operating characteristic (ROC) curves were employed to investigate the optimal cutoffs. Results: ROC analysis indicated that the optimal age for initial PSA screening was 57.5 years (AUC = 0.84), 62.5 years (AUC = 0.902), 60.5 years (AUC = 0.909), and 61.5 years (AUC = 0.890) for individuals with PSA >4 and >10 ng/mL, a diagnosis of prostate cancer (PCa), and clinically significant PCa defined as the focus events, respectively. For Chinese men aged 50–59, 60–69, and >70 years, the initial PSA levels of 1.305 ng/mL (AUC = 0.699), 1.975 ng/mL (AUC = 0.711), and 2.740 ng/mL (AUC = 0.720) might have a PSA velocity >0.75 ng/mL per year during the follow-up. In addition, the total cost amounts to CNY 13,609,260 in these cases, but only 60 of the 35,533 (0.17%) men gained benefit from PSA screening. Conclusion: In our opinion, the optimal starting age for initial PSA testing was 57.5 years. The necessity for repeat screening should be based on the first PSA level depending on age. A cost--benefit analysis should be included in population-based screening.
- Subjects
CHINA; CHINESE people; PROSTATE-specific antigen; AGE; CANCER diagnosis
- Publication
Urologia Internationalis, 2020, Vol 104, Issue 3-4, p230
- ISSN
0042-1138
- Publication type
Article
- DOI
10.1159/000503733