دورية أكاديمية
أعرض في EDS

Use of Digital Rectal Examination as an Adjunct to Prostate Specific Antigen in the Detection of Clinically Significant Prostate Cancer.

التفاصيل البيبلوغرافية
العنوان: Use of Digital Rectal Examination as an Adjunct to Prostate Specific Antigen in the Detection of Clinically Significant Prostate Cancer.
المؤلفون: Halpern JA; Department of Urology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York., Oromendia C; Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, New York., Shoag JE; Department of Urology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York., Mittal S; Department of Urology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York., Cosiano MF; Department of Urology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York., Ballman KV; Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, New York., Vickers AJ; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York., Hu JC; Department of Urology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York. Electronic address: jch9011@med.cornell.edu.
المصدر: The Journal of urology [J Urol] 2018 Apr; Vol. 199 (4), pp. 947-953. Date of Electronic Publication: 2017 Oct 20.
نوع المنشور: Journal Article; Multicenter Study; Randomized Controlled Trial
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 0376374 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-3792 (Electronic) Linking ISSN: 00225347 NLM ISO Abbreviation: J Urol Subsets: MEDLINE
أسماء مطبوعة: Publication: 2019- : [Philadelphia, PA] : Wolters Kluwer
Original Publication: Baltimore : Lippincott Williams & Wilkins
مواضيع طبية MeSH: Digital Rectal Examination/*standards , Mass Screening/*methods , Prostate-Specific Antigen/*blood , Prostatic Neoplasms/*diagnosis, Aged ; Biopsy ; Cohort Studies ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mass Screening/standards ; Middle Aged ; Practice Guidelines as Topic ; Predictive Value of Tests ; Prognosis ; Prostate/pathology ; Prostatic Neoplasms/blood ; Prostatic Neoplasms/epidemiology ; Prostatic Neoplasms/pathology ; Sensitivity and Specificity
مستخلص: Purpose: Guidelines from the NCCN ® (National Comprehensive Cancer Network®) advocate digital rectal examination screening only in men with elevated prostate specific antigen. We investigated the effect of prostate specific antigen on the association of digital rectal examination and clinically significant prostate cancer in a large American cohort.
Materials and Methods: We evaluated the records of the 35,350 men who underwent digital rectal examination in the screening arm of the Prostate, Lung, Colorectal and Ovarian Cancer Screening trial for the development of clinically significant prostate cancer (Gleason 7 or greater). Followup was 343,273 person-years. The primary outcome was the rate of clinically significant prostate cancer among men with vs without suspicious digital rectal examination. We performed competing risks regression to evaluate the interaction between time varying suspicious digital rectal examination and prostate specific antigen.
Results: A total of 1,713 clinically significant prostate cancers were detected with a 10-year cumulative incidence of 5.9% (95% CI 5.6-6.2). Higher risk was seen for suspicious vs nonsuspicious digital rectal examination. Increases in absolute risk were small and clinically irrelevant for normal (less than 2 ng/ml) prostate specific antigen (1.5% vs 0.7% risk of clinically significant prostate cancer at 10 years), clinically relevant for elevated (3 ng/ml or greater) prostate specific antigen (23.0% vs 13.7%) and modestly clinically relevant for equivocal (2 to 3 ng/ml) prostate specific antigen (6.5% vs 3.5%).
Conclusions: Digital rectal examination demonstrated prognostic usefulness when prostate specific antigen was greater than 3 ng/ml, limited usefulness for less than 2 ng/ml and marginal usefulness for 2 to 3 ng/ml. These findings support the restriction of digital rectal examination to men with higher prostate specific antigen as a reflex test to improve specificity. It should not be used as a primary screening modality to improve sensitivity.
(Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)
References: Int J Cancer. 1999 Aug 20;84(4):437-41. (PMID: 10404100)
Control Clin Trials. 2000 Dec;21(6 Suppl):273S-309S. (PMID: 11189684)
Control Clin Trials. 2000 Dec;21(6 Suppl):390S-399S. (PMID: 11189690)
J Urol. 2005 Mar;173(3):746-50; discussion 750-1. (PMID: 15711261)
J Natl Cancer Inst. 2006 Apr 19;98(8):529-34. (PMID: 16622122)
BJU Int. 2007 Mar;99(3):559-63. (PMID: 17155976)
Urology. 2006 Dec;68(6):1152-5. (PMID: 17169636)
Eur Urol. 2008 Sep;54(3):581-8. (PMID: 18423977)
N Engl J Med. 2009 Mar 26;360(13):1310-9. (PMID: 19297565)
Eur Urol. 2012 Mar;61(3):577-83. (PMID: 22104592)
J Endourol. 2013 Feb;27(2):182-8. (PMID: 22891728)
J Urol. 2013 Aug;190(2):419-26. (PMID: 23659877)
Urol Oncol. 2016 Aug;34(8):335.e21-8. (PMID: 27108226)
N Engl J Med. 2016 May 5;374(18):1795-6. (PMID: 27144870)
J Natl Compr Canc Netw. 2016 May;14(5):509-19. (PMID: 27160230)
Curr Med Res Opin. 2016 Oct;32(10):1663-1669. (PMID: 27264113)
Prostate Cancer Prostatic Dis. 2016 Dec;19(4):395-397. (PMID: 27431496)
J Urol. 2017 Feb;197(2):363-368. (PMID: 27569432)
JAMA. 1984 Dec 21;252(23):3261-4. (PMID: 6512929)
J Urol. 1994 May;151(5):1283-90. (PMID: 7512659)
JAMA. 1993 Jan 6;269(1):61-4. (PMID: 8416407)
معلومات مُعتمدة: P30 CA008748 United States CA NCI NIH HHS; P50 CA092629 United States CA NCI NIH HHS; UL1 TR000457 United States TR NCATS NIH HHS
فهرسة مساهمة: Keywords: digital rectal examination; early detection of cancer; mass screening; prostate-specific antigen; prostatic neoplasms
المشرفين على المادة: EC 3.4.21.77 (Prostate-Specific Antigen)
تواريخ الأحداث: Date Created: 20171025 Date Completed: 20190522 Latest Revision: 20200225
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC6719551
DOI: 10.1016/j.juro.2017.10.021
PMID: 29061540
قاعدة البيانات: MEDLINE
الوصف
تدمد:1527-3792
DOI:10.1016/j.juro.2017.10.021