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ORIGINAL INVESTIGATION LESS IS MORE Five-Year Downstream Outcomes Following Prostate-Specific Antigen Screening in Older Men Louise C. Walter, MD; Kathy Z. Fung, MS; Katharine A. Kirby, MS; Ying Shi, PhD; Roxanne Espaldon, BA; Sarah O’Brien, MPH; Stephen J. Freedland, MD; Adam A. Powell, PhD, MBA; Richard M. Hoffman, MD, MPH Importance: Despite ongoing controversies surround- biopsy were diagnosed as having prostate cancer, of whom ing prostate-specific antigen (PSA) screening, many men 4284 (82.1%) were treated for prostate cancer. Perfor- 65 years or older undergo screening. However, few data mance of prostate biopsy decreased with advancing age exist that quantify the chain of events following screen- and worsening comorbidity (P.001), whereas the per- ing in clinical practice to better inform decisions. centage treated for biopsy-detected cancer exceeded 75% even among men 85 years or older, those with a Charlson- Objective: To quantify 5-year downstream outcomes Deyo Comorbidity Index of 3 or higher, and those hav- following a PSA screening result exceeding 4.0 ng/mL in ing low-risk cancer. Among men with biopsy-detected can- older men. cer, the risk of death from non–prostate cancer causes increased with advancing age and worsening comorbid- Design and Setting: Longitudinal cohort study in the ity (P.001).
JAMA Internal Medicine – American Medical Association
Published: May 27, 2013
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