The prostate gland

What can go wrong with the prostate gland?

Prostate Cancer Risk Management Programme information for primary care: PSA testing in asymptomatic men. Evidence document January 2010

Colin SM, Metcalfe C, Donovan J, Lane JA, Davis M, Neal D, Hamdy F,
Martin RM. Associations of lower urinary tract symptoms with prostate-specific antigen levels, and screen detected localized and advanced prostate cancer: a case-control study nested within the UK based population ProtecT (Prostate testing for cancer and Treatment) study. BJU Int, 2008, 102 (10):1400-140

Crawford E D. Understanding the Epidemiology, Natural History and Key Pathways Involved in Prostate Cancer. 2009 Urology; 73:5A

Johansson J-E, Andren O, Andersson S O, Dickamn P W, Holmberg L, Magnuson A, Adami H O. Natural History of Early Localised Prostate Cancer, JAMA 2004; 291 (22) 2713-2719

NICE. The management of lower urinary tract symptoms in men. 2010 Prostate Cancer Risk Management Programme information for primary care: PSA testing in asymptomatic men. Evidence document January 2010

What is benign prostatic hyperplasia (BPH)?

Trueman P, Hood SC, Nayak US, Mrazek MF. Prevalence of lower urinary tract symptoms and self-reported diagnosed 'benign prostatic hyperplasia,' and their effect on quality of life in a community-based survey of men in the UK. BJU Int 1999; 83: 410-415.

Wei JT, Calhoun E, Jacobsen SJ. Urologic diseases in America project: benign prostatic hyperplasia. Journal of Urology 2005; 173: 1256-1261.

What is prostate cancer?

ISD Online. Cancer Incidence, Mortality and Survival data. Accessed 2010
Northern Ireland Cancer Registry. Cancer Incidence and Mortality. Accessed 2010
Office for National Statistics, Cancer Statistics registrations: Registrations of cancer diagnosed in 2007, England. Series MB1 no.38. 2010, National Statistics: London.
Welsh Cancer Intelligence and Surveillance Unit, Cancer Incidence in Wales. 2010

Crawford E D. Understanding the Epidemiology, Natural History and Key Pathways Involved in Prostate Cancer. 2009 Urology; 73:5A

Johansson J-E, Andren O, Andersson S O, Dickamn P W, Holmberg L, Magnuson A, Adami H O. Natural History of Early Localised Prostate Cancer, JAMA 2004; 291 (22) 2713-2719

Prostate Cancer Risk Management Programme information for primary care: PSA testing in asymptomatic men. Evidence document January 2010

Sakr WA, Grignon DJ, Haas GP, Heilbrun LK, Pontes JE, Crissman JD. Age and racial distribution of prostatic intraepithelial neoplasia. Eur Urol, 1996, 30(2):138-144.

What is my risk of developing prostate cancer?

Age
ISD Online. Cancer Incidence, Mortality and Survival data. Accessed 2010
Northern Ireland Cancer Registry. Cancer Incidence and Mortality. Accessed 2010
Office for National Statistics, Cancer Statistics registrations: Registrations of cancer diagnosed in 2007, England. Series MB1 no.38. 2010, National Statistics: London.
Welsh Cancer Intelligence and Surveillance Unit, Cancer Incidence in Wales. 2010

Family history
Dianat SS, Margreiter M, Eckersberger E, Finkelstein J, Kuehas F, Herwig R, Ayati M, Lepor H, Djavan B. Gene polymorphisms and prostate cancer: the evidence 2009 BJUI: 104 1560-1572

Elo JP and Visakorpi T.  Molecular genetics of prostate cancer. Ann Med 2001;33(2):130-41

Johns LE, Houlston RS. A systematic review and meta-analysis of familial prostate cancer risk. BJU International 2003; 91: 789-794.

McPherson K, Steel CM, Dixon JM. Breast cancer: epidemiology, risk factors and genetics. British Medical Journal 2000;321:624–8.

Ford D, Easton D, Stratton M, Narad S, Goldgar D, Devilee P, et al.Genetic heterogeneity and pebetrance analysis of the BRCA1 and BRCA2 genes in breast cancer families. American Journal of Human Genetics 1998;62:676–89.

Easton DF, Ford D, Bishop DT, and the Breast Cancer Linkage Consortium. Breast and ovarian cancer incidence in BRCA1 mutation carriers. American Journal of Human Genetics 1995;56(1): 265–71.

Edwards SM, Kote-Jarai Z, Meitz J, Hamoudi R, Hope Q, Osin P, Jackson R,
Southgate C, Singh R, Falconer A, Dearnaley DP, Ardern-Jones A, Murkin A,
Dowe A, Kelly J, Williams S, Oram R, Stevens M, Teare DM, Ponder BA,
Gayther SA, Easton DF, Eeles RA. Two percent of men with early-onset prostate
cancer harbor germline mutations in the BRCA2 gene. Am J Hum Genet, 2003,
72(1):1-12.

Thompson D, Easton DF. Cancer Incidence in BRCA1 mutation carriers. J Natl
Cancer Inst, 2002, 94(18):1358-1365.

Mitra AV, Bancroft EK, Barbachano Y et al Targeted prostate cancer screening in men with mutations in BRCA1 and BRCA2 detects aggressive prostate cancer: preliminary analysis of the results of the IMPACT study.BJU Int. 2010 Sep 14. doi: 10.1111/j.1464-410X.2010.09648.x. [Epub ahead of print]

Ethnicity
Ben-Shlomo Y, Evans S, Ibrahim F, et al  The Risk of Prostate Cancer amongst Black Men in the United Kingdom: The PROCESS Cohort Study. Eur Urol 2008; 53(1):99-105

Metcalfe C, Evans S, Ibrahim F, Patel B, Anson K, Chinegwundoh F, Corbishley C, Gillatt D, Kirby R, Muir G, Nargund V, Popert R, Persad R, Ben-Shlomo Y. Pathways to diagnosis for black men and white men found to have prostate cancer: the PROCESS cohort study. British Journal of Cancer (2008)

Xu J, Kibel AS, Hu JJ, Turner AR, Pruett K, Zheng SL, Sun J, Isaacs SD, Wiley KE, Kim ST, Hsu FC, Wu W, Torti FM, Walsh PC, Chang BL, Isaacs WB.Prostate cancer risk associated loci in African Americans Cancer Epidemiol Markers Prev 2009; 18(7) 2145-49).

Hooker S, Hernandez W, Chen H, Robbins C, Torres JB, Ahaghotu C, Carpten J, Kittles RA.Replication of prostate cancer risk loci on 8q24, 11q13, 17q12, 19q33, and Xp11 in African Americans Prostate 2010 Feb 15;70(3):270-6).

Wang Y, Ray AM, Johnson EK, Zuhlke KA, Cooney KA, Lange EM. Evidence for an association between prostate cancer and chromosome 8q24 and 10q11 genetic variants in African American men: The flint men's health study† Prostate 2010 Aug 17).

Lavender NA, Benford ML, VanCleave TT, Brock GN, Kittles RA, Moore JH, Hein DW, Kidd LC.Examination of polymorphic glutathione S-transferase (GST) genes, tobacco smoking and prostate cancer risk among Men of African Descent: A case-control study BMC Cancer 2009 9: 397)

Mason TE, Ricks-Santi L, Chen W, Apprey V, Joykutty J, Ahaghotu C, Kittles R, Bonney G, Dunston GM.Association of CD14 variant with prostate cancer in African American men Prostate 2010 Feb 15;70(3):262-9)

National Cancer Intelligent Network. Cancer incidence and survival by major ethnic group, England, 2002-2006. 

Metcalfe C, Patel B, Evans S, Ibrahim F, Anson K, Chinegwundoh F, Corbishley C, Dorling D, Thomas B, Gillatt D, Kirby R, Muir G, Nargund V, Popert R, Persad R, Ben-Shlomo Y; PROCESS Study Group. The risk of prostate cancer amongst South Asian men in southern England: the PROCESS cohort study. BJU Int. 2008 Nov;102(10):1407-12.

Ford D, Easton D, Stratton M, Narad S, Goldgar D, Devilee P, et al.Genetic heterogeneity and pebetrance analysis of the BRCA1 and BRCA2 genes in breast cancer families. American Journal of Human Genetics 1998;62:676–89.

Diet
Allen NE, Key TJ, Appleby PN et al. Animal foods, protein, calcium and prostate cancer risk: the European Prospective Investigation into Cancer and Nutrition. Br J Cancer. 2008 May 6;98(9):1574-81.

Gao X, LaValley MP, Tucker KL. Prospective Studies of dairy product and calcium intakes and prostate cancer risk: A meta-analysis. J Natl Cancer Inst. 2005;97(23):1768-77

Giovannucci E, Liu Y, Platz EA, Stampfer MJ, Willett WC. Risk factors for prostate cancer incidence and progression in the health professionals follow-up study. Int.J Cancer 2007; 121 (7):1571-8

Ma RW, Chapman K.  A systematic review of the effect of diet in prostate cancer prevention and treatment.  Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association 2009, 22(3):187-99

Orsini N, Bellocco R, Bottai M, Pagano M, Andersson SO, Johansson JE, Giovannucci E, Wolk A. A prospective study of lifetime physical activity and prostate cancer incidence and mortality Br J Cancer. 2009 Dec 1;101(11):1932-8. Epub 2009 Oct 27.

World Cancer Research Fund/American Institute for Cancer. Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective. Washington DC:AICR, 2007

Visiting your GP

What could affect my PSA level?
Price CP, Allard J, Davies G, Dawnay A, Duffy MJ, France M, Mandarino G, Ward AM, Patel B, Sibley P, Sturgeon C. Pre- and post-analytical factors that may influence the use of serum prostate specific antigen and its isoforms in a screening programme for prostate cancer. Ann Clin Biochem 2001; 38: 188-216.

Prostate Cancer Risk Management Programme information for primary care: PSA testing in asymptomatic men. Evidence document January 2010

Regular PSA tests
D’Amico et al. Pretreatment  PSA velocity and risk of death from prostate cancer following external beam radiotherapy. JAMA 2005: 294 (4)

D’Amico et al. Preoperative PSA velocity and risk of death from prostate cancer after radical prostatectomy. N Engl J Med. 2004: 351 (2)

Carter HB et al. Detection of life-threatening prostate cancer with prostate-specific antigen velocity during a window of curability. J Nat Cancer Inst 2006;98: 1521-1527

Loeb, Carter et al. Distribution of PSA velocity total PSA levels: data from the Baltimore study of aging. Urology 2011; 77 (1)

Vickers et al. Systematic review of pretreatment prostate-specific antigen velocity and doubling time as predictors for prostate cancer. J Clin Oncol 2009;27:398-403

Vickers et al. An empirical evaluation of guidelines on prostate-specific antigen velocity in prostate cancer detection. J Nat Cancer Inst 2011;13 (4):616-7Digital rectal examination (DRE)
Prostate Cancer Risk Management Programme information for primary care; PSA testing in asymptomatic men. Evidence document January 2010

Seeing a specialist

TRUS guided biopsy
PCRMP Guide no1. Undertaking a transrectal ultrasound guided biopsy of the prostate. Dec 2006

What are the disadvantages of having a biopsy?
Eichler K, Hempel S, Wilby J, Myers L, Bachmann LM, Kleijnen J. Diagnostic value of systematic prostate biopsy methods in the investigation for prostate cancer: a systematic review. Centre for Reviews and Dissemination, University of York; 2005.

Making a decision

Draisma G, Boer R, Otto SJ, van der Cruijsen IW, Damhuis RA, Schröder FH, de Koning HJ. Lead times and overdetection due to prostate-specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst 2003; 95(12): 868-878.

Etzioni R, Penson DF, Legler JM, di Tommaso D, Boer R, Gann PH, Feuer EJ. Overdiagnosis due to prostate-specific antigen screening: lessons from US prostate cancer incidence trends. J Natl Cancer Inst. 2002; 94: 981-990.

Prostate Cancer Risk Management Programme information for primary care; PSA testing in asymptomatic men. Evidence document January 2010

Selley S, Donovan J, Faulkner A, Coast J, Gillatt D. Diagnosis, management and screening of early localised prostate cancer. Health Technol Assess 1997;1(2):i, 1-i,96.

Stamey TA, Caldwell M, McNeal JE, Nolley R, Hemenez M, Downs J. The prostate specific antigen era in the United States is over for prostate cancer: what happened in the last 20 years? J Urol. 2004; 172: 1297-301.

Yao SL, Lu-Yao G. Understanding and appreciating overdiagnosis in the PSA era. J Natl Cancer Inst. 2002; 94: 958-960.

Why is there no screening programme for all men?

Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, Kwiatkowski M, Lujan M, Lilja H, Zappa M, Denis LJ, Recker F, Berenguer A, Määttänen L, Bangma CH, Aus G, Villers A, Rebillard X, van der Kwast T, Blijenberg BG, Moss SM, de Koning HJ, Auvinen A. Screening and prostate-cancer mortality in a randomized European study N Engl J Med. 2009 Mar 26;360(13):1320-8. Epub 2009 Mar 18.

Other tests

Catalone W J, Partin AW, SLawin KM, et al. Use of percentage of free prostate-specific antigen to enhance differentiaion of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial. JAMA 1998; 279: 1542-7

Froehner M, Buck L M, Koch R, Hakenburg O W, Wirth M P. Derivatives of prostate specific antigen as predictors of incidental prostate cancer. BJUI 2009 104, 25-28
Noguerira L, Corradi R, Eastham J. Other biomarkers for detecting prostate cancer. BJUI 2009 105, 166-169

Schilling D, de Reijke T, Tombal B, de la Taille A, Hennenlotter J, Stenzl A. The Prostate Cancer gene 3 assay: indications for use in clinical practice. BJU I 2009 105, 452-455


Schilling D, de Reijke T, Tombal B, de la Taille A, Hennenlotter J, Stenzl A Follow-up of men with an elevated PCA3 score and a negative biopsy: does an elevated PCA3 score indeed predict the presence of prostate cancer? BJU Int. 2010 Feb;105(4):452-5.