ArticleCancer research2013
Gleason grade progression is uncommon.
Article in Cancer research, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The role of endogenous testosterone in relationship with low- and intermediate-risk prostate cancer: a systematic review.Asian journal of andrology · 2024Pooled it
- Marital status and prostate cancer incidence: a pooled analysis of 12 case-control studies from the PRACTICAL consortium.European journal of epidemiology · 2021Pooled it
- Mechanisms of Progression and Challenges for Intervention in the Natural History of Early Prostate Cancer: A Narrative Review.Current oncology (Toronto, Ont.) · 2026Review
- Occupational Exposure to Engine Exhausts and Prostate Cancer Risk.Environmental health : a global access science source · 2025Article
- Time-varying associations of patient and tumor characteristics with cancer survival: an analysis of SEER data across 14 cancer sites, 2004-2017.Cancer causes & control : CCC · 2024Article
- Neighbourhood social deprivation and risk of prostate cancer.British journal of cancer · 2023Article
- Grade Group accuracy is improved by extensive prostate biopsy sampling, but unrelated to prostatectomy specimen sampling or use of immunohistochemistry.Pathology oncology research : POR · 2023Article
- Association of Prostate-Specific Antigen Levels with Prostate Cancer Risk in a Multiethnic Population: Stability Over Time and Comparison with Polygenic Risk Score.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022Article
- Differences in Prostate Cancer Transcriptomes by Age at Diagnosis: Are Primary Tumors from Older Men Inherently Different?Cancer prevention research (Philadelphia, Pa.) · 2022Article
- Article
- Single-cell proteomics defines the cellular heterogeneity of localized prostate cancer.Cell reports. Medicine · 2022Article
- Article
- Co-Targeting Plk1 and DNMT3a in Advanced Prostate Cancer.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2021Article
- Preoperative exercise interventions to optimize continence outcomes following radical prostatectomy.Nature reviews. Urology · 2021Review
- Serial Molecular Profiling of Low-grade Prostate Cancer to Assess Tumor Upgrading: A Longitudinal Cohort Study.European urology · 2021Article
- miR-145-5p: A Potential Biomarker in Predicting Gleason Upgrading of Prostate Biopsy Samples Scored 3+3=6.Cancer management and research · 2021Article
- Molecular and Clinical Relevance ofCancers · 2020Article
- Cyclooxygenase-2 inhibitors delay relapse and reduce Prostate Specific Antigen (PSA) velocity in patients treated with radiotherapy for nonmetastatic prostate cancer: a pilot study.Prostate international · 2020Article
- TIP5 primes prostate luminal cells for the oncogenic transformation mediated byProceedings of the National Academy of Sciences of the United States of America · 2020Article
- Association of statin use with risk of Gleason score-specific prostate cancer: A hospital-based cohort study.Cancer medicine · 2019Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
Gleason grade is universally used for pathologic scoring of the differentiation of prostate cancer. However, it is unknown whether prostate tumors arise well differentiated and then progress to less differentiated forms or if Gleason grade is an early and largely unchanging feature. Prostate-specific antigen (PSA) screening has reduced the proportion of tumors diagnosed at advanced stage, which allows assessment of this question on a population level. If Gleason grade progresses as stage does, one would expect a similar reduction in high-grade tumors. We studied 1,207 Physicians' Health Study and Health Professionals Follow-up Study participants diagnosed with prostate cancer from 1982 to 2004 and treated with prostatectomy. We compared the distribution of grade and clinical stage across the pre-PSA and PSA screening eras. We re-reviewed grade using the ISUP 2005 revised criteria. The proportion of advanced stage tumors dropped more than six-fold, from the earliest period (12/1982-1/1993), 19.9% stage ≥ T3, to the latest (5/2000-12/2004), 3% stage T3, none T4. The proportion of Gleason score ≥ 8 decreased substantially less, from 25.3% to 17.6%. A significant interaction between stage and diagnosis date predicting grade (P = 0.04) suggests that the relationship between grade and stage varies by time period. As the dramatic shift in stage since the introduction of PSA screening was accompanied by a more modest shift in Gleason grade, these findings suggest that grade may be established early in tumor pathogenesis. This has implications for the understanding of tumor progression and prognosis, and may help patients diagnosed with lower grade disease feel more comfortable choosing active surveillance.
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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.