ArticleBMJ (Clinical research ed.)2010
Prostate specific antigen concentration at age 60 and death or metastasis from prostate cancer: case-control study.
Article in BMJ (Clinical research ed.), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 105 papers, 4 of them syntheses that pooled it.
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Who cites it
105 citing papers in PubMed, 4 syntheses or guidelines pooled it, 237 citations in OpenAlex.
- Guideline of guidelines: a critical appraisal of the evidence for PSA retesting intervals.BJU international · 2025Pooled it
- Early Detection of Prostate Cancer: AUA/SUO Guideline Part I: Prostate Cancer Screening.The Journal of urology · 2023Guideline
- Properties of the 4-Kallikrein Panel Outside the Diagnostic Gray Zone: Meta-Analysis of Patients with Positive Digital Rectal Examination or Prostate Specific Antigen 10 ng/ml and Above.The Journal of urology · 2017Pooled it
- Early detection of prostate cancer: AUA Guideline.The Journal of urology · 2013Guideline
- Relationship Between Baseline Prostate-specific Antigen on Cancer Detection and Prostate Cancer Death: Long-term Follow-up from the European Randomized Study of Screening for Prostate Cancer.European urology · 2023Trial
- Trial
- Screening for Prostate Cancer Starting at Age 50-54 Years. A Population-based Cohort Study.European urology · 2017Trial
- Design and preliminary recruitment results of the Cluster randomised triAl of PSA testing for Prostate cancer (CAP).British journal of cancer · 2014Trial
- Empirical estimates of prostate cancer overdiagnosis by age and prostate-specific antigen.BMC medicine · 2014Trial
- The Prognostic Value of Baseline PSA Density on Long-term Oncological Outcomes in Men with an Initial Negative Prostate Biopsy: Results from ERSPC Rotterdam.European urology open science · 2026Article
- Polygenic risk score and 20-year prostate cancer-specific mortality and survival.Communications medicine · 2026Article
- Joint Biochemical and Genetic Prostate Cancer Risk Stratification.The Journal of urology · 2026Article
- Prostate-specific antigen levels at age 60 years and lifetime risk of lethal prostate cancer.Journal of the National Cancer Institute · 2025Article
- Prostate specific antigen retesting intervals and trends in England: population based cohort study.BMJ (Clinical research ed.) · 2025Article
- Five things you need to know about prostate cancer diagnostic tests.Asian journal of urology · 2025Article
- Prostate cancer screening.Asian journal of urology · 2025Review
- Emerging tools for the early detection of prostate cancer.BJUI compass · 2025Review
- An interpretable clinical-radiomics-deep learning model based on magnetic resonance imaging for predicting postoperative Gleason grading in prostate cancer: a dual-center study.Frontiers in oncology · 2025Article
- The Role of Baseline Prostate-specific Antigen Value Prior to Age 60 in Predicting Lethal Prostate Cancer: Analysis of a Contemporary North American Cohort.European urology oncology · 2024Article
- Designed ankyrin repeat proteins for detecting prostate-specific antigen expressionRSC chemical biology · 2023Article
45 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveTo determine the relation between concentrations of prostate specific antigen at age 60 and subsequent diagnosis of clinically relevant prostate cancer in an unscreened population to evaluate whether screening for prostate cancer and chemoprevention could be stratified by risk.
designCase-control study with 1:3 matching nested within a highly representative population based cohort study.
settingGeneral population of Sweden taking part in the Malmo Preventive Project. Cancer registry at the National Board of Health and Welfare.
participants1167 men aged 60 who provided blood samples in 1981 and were followed up to age 85.
main outcome measuresMetastasis or death from prostate cancer.
resultsThe rate of screening during the course of the study was low. There were 43 cases of metastasis and 35 deaths from prostate cancer. Concentration of prostate specific antigen at age 60 was associated with prostate cancer metastasis (area under the curve 0.86, 95% confidence interval 0.79 to 0.92; P<0.001) and death from prostate cancer (0.90, 0.84 to 0.96; P<0.001). The greater the number for the area under the curve (values from 0 to 1) the better the test. Although only a minority of the men with concentrations in the top quarter (>2 ng/ml) develop fatal prostate cancer, 90% (78% to 100%) of deaths from prostate cancer occurred in these men. Conversely, men aged 60 with concentrations at the median or lower (≤1 ng/ml) were unlikely to have clinically relevant prostate cancer (0.5% risk of metastasis by age 85 and 0.2% risk of death from prostate cancer).
conclusionsThe concentration of prostate specific antigen at age 60 predicts lifetime risk of metastasis and death from prostate cancer. Though men aged 60 with concentrations below the median (≤1 ng/ml) might harbour prostate cancer, it is unlikely to become life threatening. Such men could be exempted from further screening, which should instead focus on men with higher concentrations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.