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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Hi all:<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>For the ”men in your life”.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>A good article that backs up the establishment of a baseline PSA level at age 40.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Pass it on to friends and relatives.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Take care,<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Glen</span><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'> Tolhurst</span><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p></o:p></span></p><p class=MsoNormal><o:p> </o:p></p><h1>Single PSA Test Predicts Prostate Cancer Risk<o:p></o:p></h1><div><p class=MsoNormal>By Charles Bankhead, Staff Writer, MedPage Today<o:p></o:p></p><p><span style='color:#666666'>Published: May 23, 2012</span><o:p></o:p></p><p>Reviewed by <a href="http://www.medpagetoday.com/reviewer.cfm?reviewerid=512">Dori F. Zaleznik, MD</a>; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, BSN, RN, Nurse Planner<o:p></o:p></p></div><p class=MsoNormal> <o:p></o:p></p><p>ATLANTA – <span style='background:yellow;mso-highlight:yellow'>A baseline prostate-specific antigen (PSA) value of less than 1 ng/mL predicted a low risk of prostate cancer over the next 15 years in men younger than 50, none of whom developed intermediate- or high-risk cancer,</span> data from a longitudinal cohort study showed.<o:p></o:p></p><p>During a median follow-up of 16.8 years, six prostate cancers occurred in men with baseline PSA values <1 ng/mL. All of the tumors had low-risk characteristics.<o:p></o:p></p><p>Men with low PSA values at initial measurement had a prostate cancer incidence of <1% at age 55 and <3% at 60, Christopher Weight, MD, reported here at the American Urological Association (AUA) meeting.<o:p></o:p></p><p>"Baseline PSA in men younger than 50 can risk-stratify men for prostate cancer," Weight, a urology resident at Mayo Clinic in Rochester, Minn., said during an AUA press briefing. "Men with a baseline PSA ≥1 ng/mL have a substantial risk of subsequent biopsy and cancer diagnosis and should be followed annually.<o:p></o:p></p><p>"Men with a baseline PSA <1.0 ng/mL in their 40s appear to be able to safely avoid annual screening until age 55."<o:p></o:p></p><p>Since 2009 the AUA has recommended PSA testing as a screen for prostate cancer beginning at age 40. However, limited population-based screening data exist to characterize trends in prostate cancer in the younger age group and to assess the impact of PSA testing on the trends.<o:p></o:p></p><p>Since 1990 investigators at Mayo Clinic have prospectively followed a random sample of men ages 40 to 49 from Olmsted County, Minn. Each man had PSA assessment, digital rectal exam (DRE), and transurethral ultrasound at entry and then biennially thereafter.<o:p></o:p></p><p>Weight said investigators have examined three principal outcomes during follow-up of the cohort: <o:p></o:p></p><ul type=disc><li class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo3'>Risk of prostate biopsy and prostate cancer<o:p></o:p></li><li class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo3'>Stage and Gleason score of diagnosed cancers<o:p></o:p></li><li class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo3'>Long-term prostate cancer risk in men with a baseline PSA <1 ng/mL at age 40 to 49<o:p></o:p></li></ul><p>The initial PSA value was <1 ng/mL in 192 men and ≥1 ng/mL in 76 men. The two groups did not differ significantly with respect to DRE findings or family history of prostate cancer.<o:p></o:p></p><p>The six cases of diagnosed prostate cancer in the low-PSA group translated into an incidence rate of 1.6 per 1,000 patient-years. In contrast, men who had an initial PSA measurement ≥1 ng/mL subsequently developed 12 cancers, resulting in an incidence rate of 8.3 per 1,000 patient years.<o:p></o:p></p><p>Two men with higher baseline PSA values developed intermediate- to high-risk cancers as compared with none in the low-PSA group. The median time to cancer diagnosis was 14.6 years in the low-PSA group and 10.3 years in men with higher baseline PSA measurements.<o:p></o:p></p><p>Analysis of receiver operating characteristic area under the curve (AUC) showed that a baseline PSA cutoff of 1 ng/mL was associated with an AUC of 0.73 for diagnosis of any prostate cancer and an AUC of 0.85 for diagnosis of Gleason score ≥7 cancers.<o:p></o:p></p><p>The 1 ng/mL cutoff also proved useful for stratifying patients into low- and high-risk subgroups for prostate biopsy, said Weight.<o:p></o:p></p><p>The press briefing occurred within the context of the U.S. Preventive Services Task Force <a href="http://www.medpagetoday.com/MeetingCoverage/AUA/32817" target="_blank" title="Prevention Panel: No Need for PSA Test">final recommendation</a> against PSA testing as a prostate cancer screen. Weight alluded to the recommendation in his comments.<o:p></o:p></p><p>"There is danger in completely throwing out the PSA, and I think that is illustrated here," he said. "There are very few tests that, with one single blood test, can produce an area under the curve this high."<o:p></o:p></p><p>"I think we can potentially use PSA a little differently than we have in the past and eliminate some of the overdiagnosis and overtreatment by risk-stratifying better, which will also help maintain the benefits of PSA screening."<o:p></o:p></p><p>Press briefing moderator Scott Eggener said the risk-stratification strategy suggested by the results offers a reasonable means to balance the benefits and potential harms of PSA screening.<o:p></o:p></p><p>"The goal of any screening test -- or many things we do in medicine -- is to try to identify the cohort of patients who are most likely to benefit and give them the test; hopefully we will then screen, diagnose early, treat early, and cure the cancer," said Eggener, of the University of Chicago.<o:p></o:p></p><p>"The other goal is to identify people who don't need intensive screening or don't need screening at all, and then stand back a little bit to maximize the benefit and minimize the harm."<o:p></o:p></p><div style='border:solid #8DABBC 1.0pt;padding:4.0pt 4.0pt 4.0pt 4.0pt;float:left'><p style='background:#DBE9F2'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Neither Weight nor Eggener had any relevant disclosures.<o:p></o:p></span></p></div><div><p><b>Primary source: </b>American Urological Association<br>Source reference:<br><a href="http://www.auanet.org" target="_blank">Weight C et al "Young men (ages 40-49) with a single baseline PSA below 1.0 ng/mL are at very low 10-15 year risk of prostate cancer" <em>AUA </em>2012; Abstract 1219.</a><o:p></o:p></p></div><p class=MsoNormal><o:p> </o:p></p><p>__________ Information from ESET Smart Security, version of virus signature database 7172 (20120527) __________<o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p>The message was checked by ESET Smart Security.<o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p><a href="http://www.eset.com">http://www.eset.com</a><o:p></o:p></p><p class=MsoNormal><br><br>__________ Information from ESET Smart Security, version of virus signature database 7172 (20120527) __________<br><br>The message was checked by ESET Smart Security.<br><br><a href="http://www.eset.com">http://www.eset.com</a><o:p></o:p></p><p class=MsoNormal><br><br>__________ Information from ESET Smart Security, version of virus signature database 7173 (20120527) __________<br><br>The message was checked by ESET Smart Security.<br><br><a href="http://www.eset.com">http://www.eset.com</a><o:p></o:p></p></div> <BR><BR>__________ Information from ESET Smart Security, version of virus signature database 7173 (20120527) __________<BR><BR>The message was checked by ESET Smart Security.<BR><BR><A HREF="http://www.eset.com">http://www.eset.com</A><BR> </body></html>