20 Jan Cancer-Related Mortality Low In Men With Benign Prostate Biopsy
MedicalResearch.com Interview with:
Dr. Nina Klemann
Copenhagen Prostate Cancer Center
MedicalResearch.com: What is the background for this study?
Response: For 30 years, ultrasound-guided biopsies of the prostate have been used in the evaluation of men suspected for prostate cancer. The biopsy needles are employed systematically into the prostate at different sites where prostate cancer is typically present. However, it has been recognized for years, that there is a risk of not hitting the cancer areas, simply by chance. Although cancer diagnosis may be missed in the initial biopsy set by sampling error, it has been a continuous debate whether lethal prostate cancer is missed. Today, we know that prostate cancer is a common finding in men age 50-80, but that the life-time risk of prostate cancer death in this age-group is low. Consequently, we know that there is a considerable risk of diagnosing, and ultimately treating, a disease that will never result in symptoms or death.
MedicalResearch.com: What are the main findings?
Response: In this study we analyzed the risk of prostate cancer mortality in all Danish men who were referred for biopsy evaluation in the suspicion of prostate cancer. The study, the largest to date of its kind, included 64,000 men referred for prostate biopsy. Among these, we identified 27.000 men who did not show prostate cancer in the initial biopsy set and we then calculated their risk of prostate cancer death.
We found that the 20-year risk of dying of prostate cancer is 5% if the initial biopsy set is negative. In comparison, the risk of death from other causes is 60%. When adding the level of prostate-specific antigen (PSA) to this prediction, the risk of prostate cancer mortality was 0.7% in men with a normal biopsy and a PSA less than 10 ng/ml. This should be balanced against a 30-times higher risk of dying of other causes.
MedicalResearch.com: What should readers take away from your report?
Response: It can be concluded from our study, that the risk of cancer-related mortality in men who present with a normal biopsy set of the prostate is very low, especially in men with a low PSA at referral. It must be recognized that the risk of other-cause mortality far exceeds the risk of prostate cancer mortality in men who present with a negative initial biopsy, and this should be considered when discussing the need for further biopsies with the patient. We urge for international guidelines on diagnostic and follow-up strategy in men with a normal initial prostate biopsy set.
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Risk of prostate cancer diagnosis and mortality in men with a benign initial transrectal ultrasound-guided biopsy set: a population-based study
Klemann, Nina et al.
The Lancet Oncology , Volume 0 , Issue 0 ,
Published: 13 January 2017
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