Trends of clinical symptoms and prognosis of middle-aged prostate cancer patients after instigation of prostate specific antigen-based population screening

PURPOSE: Due to the low rate of screening for prostate cancer in Japan, the incidence rates of cancer are high. We have established a prostate-specific antigen (PSA)-based screening system for prostate cancer in our region. We analyzed recent trends of clinical symptoms and prognosis of prostate cancer patients aged 55 to 69 years old in our institution. METHODS: Between 2000 and 2007, 162 cases of prostate cancer in patients aged 55 to 69 years old were newly diagnosed. The study population was divided into 119 cases with high PSA without symptoms, 36 cases with urological symptoms, and 7 cases with systemic symptoms. We analyzed the clinical courses of the patients in each group. RESULTS: The rate of localized disease was significantly higher in the PSA testing group than in the other groups. The median serum PSA levels were 1,600 ng/mL in the systemic symptom group, 13.3 ng/mL in the urological symptom group, and 7.1 ng/mL in the PSA testing group. The probability of nonrecurrence of the patients in the PSA testing group was significantly higher than in the other groups. CONCLUSIONS: The rate of prostate cancer patients diagnosed by PSA testing was relatively high in our institution. These patients have better prognosis than those with symptoms.