PROSTATE CANCER SCREENING CURRENT CLINICAL UROLOGY Eric A. Klein, SERIES EDITOR Prostate Cancer Screening, edited by Ian M. Thompson, Martin I. Resnick, and Eric A. Klein, 2001 Bladder Cancer: Current Diagnosis and Treatment, edited by Michael J. Droller, 2001 Office Urology: The Clinician's Guide, edited by Elroy D. Kursh and James C. Ulchaker, 2001 Voiding Dysfunction: Diagnosis and Treatment, edited by Rodney A. Appell, 2000 Management of Prostate Cancer, edited by Eric A. Klein, 2000 PROSTATE CANCER SCREENING Edited by IAN M. THOMPSON, MD The University ofT exas Health Science Center at San Antonio San Antonio, TX MARTIN I. RESNICK, MD Case western Reserve University University Hospitals ofC leveland Cleveland, OH ERIC A. KLEIN, MD Cleveland Clinic Foundation Cleveland, OH ~ ~ SPRINGER SCIENCE+BUSINESS MEDIA, LLC © 2001 Springer Seienee+Business Media New York OriginalIy published by Humana Press Ine. in 2001 AII rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise without written permission from the Publisher. AlI articles, comments, opinions, conclusions, or recommendations are those of the author(s), and do not neces- sarily reflect the views of the publisher. Due diligence has been taken by the publishers, editors, and authors of this book to ensure the accuracy of the information published and to describe generalIy accepted practices. The contributors herein have care- fulIy checked to ensure that the drug selections and dosages set forth in this text are aceurate in accord with the standards accepted at the time of publication. Notwithstanding, as new research, changes in government regulations, and knowledge from clinical experience relating to drng therapy and drug reactions constantly occurs, the reader is advised to check the product information provided by the manufacturer of each drug for any change in dosages or for additional warnings and contraindications. This is of utmost importance when the recommended drug herein is a new or infrequently used drug. It is the responsibility of the health care provider to ascertain the Food and Drug Administration status of each drug or device used in their clinic al practice. The publisher, editors, and authors are not responsible for errors or omissions or for any con se- quences from the application of the information presented in this book and make no warranty, express or implied, with respect to the contents in this publication. This publication is printed on acid-free paper. <§) ANSI Z39.48-1984 (American National Standards Institute) Permanence of Paper for Printed Library Materials. Cover Design: Patricia F. Cleary Photoeopy Authorization Policy: Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by Springer Seienee+Business Media, LLC. provided that the base fee of US $8.00 per copy, plus US $00.25 per page, is paid directly to the Copyright Clearance Center at 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license from the CCC, a separate system of payment has been arranged and is acceptable to Springer Science+Business Media, LLC. ThefeecodeforusersoftheTransactional Reporting Service is: [0-89603-901-3/01 $10.00 + $00.25]. Library of Congress Cataloging-in-Publication Data Prostate cancer screening / edited by lan M. Thompson, Martin 1. Resnick, Eric A. Klein. p. ;cm.-(Current Clinic al Urology) Includes bibliographical referenees and index. ISBN 978-1-4757-6306-5 ISBN 978-1-59259-099-5 (eBook) DOI 10.1007/978-1-59259-099-5 1. Prostate-Cancer-Diagnosis. 2. Medical sereening. 1. Thompson, lan M. (lan Murchie), 1954- II. Resnick, Martin 1. III. Klein Erie A., 1955- IV. Series. [DNLM: 1. Prostatie Neoplasms-diagnosis. 2. Mass Screening. 3. Prostate-Specific Antigen. WJ 752 P96554 2000] RC280.P7 P75985 2000 616.99'463075-de21 00-044884 PREFACE Perhaps no other subject in medicine has prompted such discussion, often with some animosity and certainly always with animation, as has the subject of screening for prostate cancer. Prior to the development of prostate specific antigen, screening was only a curiosity-an anecdote periodically due to the haphazard application of digital rectal examination. With PSA, however, screening was not only possible, but many men were found with the disease. The rate of increase in prostate cancer diagnoses in the late 1980s and early 1990s was unsurpassed by any other tumor in the history of modem public health statistics. We may never know all the "right" answers regarding prostate cancer screening. We are currently awaiting the completion of very large clinical trials in Europe and the United States, designed to answer the question. However, for the man at risk for the disease and for his physician, be it urologist, internist, or family physician, the issue is: What to do now? Prostate Cancer Screening is designed to help answer many of these ques- tions. A balanced set of discussions is included that will provide an excellent, in-depth understanding for the physician and for the patient who strive to understand as much as possible about the disease and screening. This book is also designed for health care organizations that are struggling with the applica- tion of varying recommendations from medical specialty organizations. There is no right answer, only choices. The premise of Prostate Cancer Screening is that, armed with information and augmented by personal priorities and expectations, both patients and physicians can make informed choices. If that is achieved, we have attained our goal. Ian Thompson, MD Martin I. Resnick, MD Eric A. Klein, MD v CONTENTS Preface .......................................................................................... v List of Contributors ....................................................................... ix 1 Epidemiology of Prostate Cancer Wael A. Sakr and Clara Ward ............................................ 1 2 Natural History of Prostate Cancer Peter C. Albertsen ............................................................. 25 3 Mathematical Issues: PSA Testing Ruth Etzioni and David F. Penson .................................. 47 4 Evidence of Benefit of Screening in Other Cancers Ismail Jatoi ......................................................................... 63 5 The Role of Prostate Specific Antigen and Its Variants in Prostate Cancer Screening Faiyaaz M. Jhaveri, Michael K. Brawer, and Eric A. Klein ........................................................... 79 6 The Digital Rectal Examination in Prostate Cancer Screening Joseph Basler .................................................................... 91 7 Philosophical Reflections on PSA Screening: What Should We Now Think and Do? Paul H. Lange ..................................................................... 97 8 Imaging in Prostate Cancer Screening Aaron Sulman and Martin I. Resnick ............................ 105 9 Risk Factors for Prostate Cancer David L. Shepherd. .......................................................... 131 10 Transrectal Ultrasound and Artificial Neural Networks in the Diagnosis of Prostate Cancer Til/mann Loch .................................................................. 147 11 Evidence of the Effectiveness of Prostate Cancer Screening Chris Magee and Ian M. Thompson .............................. 157 vii viii Contents 12 Prostate Cancer Screening: A Note of Caution Otis W. Brawley ............................................................... 175 13 Quality of Life and Health Behavior in Prostate Cancer Screening Populations Mark S. Litwin and Kristen A. Reid ............................... 187 14 Prostate Cancer Screening Recommendations from Organized Medicine Gregory T. Sweat ............................................................. 209 15 Informed Consent and Prostate Specific Antigen Screening: What Patients Ought to Know Evelyn C. Y. Chan ............................................................ 223 16 Experience of Prostate Cancer Awareness Week Zinelabidine Abouelfadel and E. David Crawford ...... 239 17 The Laval University Screening Trial Results Fernand Labrie, Bernard Candas, Lionel Cusan, and Jose-Luis Gomez ................................................ 255 18 Cancer of the Prostate Risk Index Test and Software (CAPRI) [CAPRI SOFTWARE ON ATTACHED CD ROM] Scott A. Optenberg, Atanacio C. Guillen, John P. Campbell, and Ian M. Thompson ............... 281 19 The European Randomized Study of Screening for Prostate Cancer (ERSPC) Fritz H. Schroder and Ingrid van der Cruijsen-Koeter for the ERSPC Study Group ................................................................ 291 Index ......................................................................................... 311 CONTRIBUTORS ZINELABIDINE ABOUELFADEL, MD • Division of Urology, University of Colorado Health Sciences Center, Denver, CO PETER C. ALBERTSEN, MD • Division of Urology, University of Connecticut Health Center, Farmington, CT JOSEPH BASLER, PhD, MD • Division of Urology, University of Texas Health Science Center, San Antonio, TX MICHAEL K. BRAWER, MD· Northwest Prostate Institute, Seattle, WA OTIS W. BRAWLEY, MD· Assistant Director, National Cancer Institute, National Institutes of Health, Bethesda, MD JOHN P. CAMPBELL, MS • Systems Analyst, Litton/PRC, San Antonio, TX BERNARD CANDAS, PhD • Prostate Cancer Clinical Research Unit, Department of Medicine ad Oncology and Molecular Endocrinology Research Center, Laval University Hospital (CHUL), Quebec, Canada EVELYN C. Y. CHAN, MD, MS • Assistant Professor and Director, Clinical Bioethics, Division of General Internal Medicine, Department ofM edicine, The University of Texas-Houston Health Science Center, Houston, TX E. DAVID CRAWFORD, MD • Division of Urology, University of Colorado Health Sciences Center, Denver, CO LIONEL CUSAN, MD, PhD· Prostate Cancer Clinical Research Unit, Department of Medicine ad Oncology and Molecular Endocrinology Research Center, Laval University Hospital (CHUL), Quebec, Canada RUTH ETZIONI • Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA JosE-LUIS GOMEZ, MD, PhD • Prostate Cancer Clinical Research Unit, Department ofM edicine ad Oncology and Molecular Endocrinology Research Center, Laval University Hospital (CHUL), Quebec, Canada ATANACIO C. GUILLEN, MS • Systems Analyst, Litton/PRC, San Antonio, TX ISMAIL JATO!, MD, PhD, FACS • Uniformed Services University of the Health Sciences, Bethesda, MD and Brooke Army Medical Center, Fort Sam Houston, TX FAIYAAZ M. JHAVERI, MD • Northwest Prostate Institute, Seattle, WA ERIC A. KLEIN, MD • Department of Urology, Cleveland Clinic Foundation, Cleveland, OH ix x Contributors FERNAND LABRIE, MD, PhD • Prostate Cancer Clinical Research Unit, Department of Medicine ad Oncology and Molecular Endocrinology Research Center, Laval University Hospital (CHUL), Quebec, Canada PAUL H. LANGE, MD· Department of Urology, University of Washington School of Medicine, Seattle, WA MARK S. LITWIN, MD, MPH • Departments of Urology and Health Services, University of California, Los Angeles, CA TILLMAN LOCH, MD, PhD· Klinik und Poliklinikfiir Urologie und Kinderurologie der Universitdt des Saarlandes, Homburg, Germany CHRIS MAGEE, MD • Division of Urology, the University of Texas Health Sciences Center at San Antonio, San Antonio, TX SCOTT A. OPTENBERG, PhD • Professor, Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX DAVID F. PENSON • Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA KRISTEN A. REID, BA • Departments of Urology and Health Services, University of California, Los Angeles, CA MARTIN I. RESNICK, MD • Chairman, Department of Urology, School ofM edicine, Case Western Reserve University, Cleveland, OH WAEL A. SAKR, MD • Department of Pathology, Wayne State University, and the Karmanos Cancer Institute, Detroit, MI FRITZ H. SCHRODER, MD, PhD • Professor and Chairman, Department of Urology, Erasmus University and Academic Hospital Rotterdam, The Netherlands DAVID L. SHEPHERD, MD • Division of Urology, Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX AARON SULMAN, MD • Department of Urology, School ofM edicine, Case Western Reserve University, Cleveland, OH GREGORY T. SWEAT, MD· Senior Associate Consultant, Department of Family Medicine, Mayo Medical School, Mayo Clinic, Rochester, MN IAN M. THOMPSON, MD • Professor and Chief, Division of Urology, The University of Texas Health Science Center at San Antonio, San Antonio, TX INGRID VAN DER CRUIJSEN-KOETER, MD • Department of Urology, Academic Hospital and Erasmus University Rotterdam, The Netherlands CLARA WARD, MD • Department of Pathology, Wayne State University, and the Karmanos Cancer Institute, Detroit, MI 1 Epidemiology of Prostate Cancer Wael A. Sakr, MD and Clara Ward, MA CONTENTS INTRODUCTION RISK FACTORS EPIDEMIOLOGY OF THE EARL Y PROSTATIC NEOPLASIA CHANGES IN PROST AT E CANCER EPIDEMIOLOGY DURING THE PSA ERA REFERENCES INTRODUCTION The approach we followed to review the epidemiology of prostate cancer was to divide this chapter into three major sections. The first section provides a brief summary of the prevalence, incidence, and mortality data worldwide and in the United States. These data are com- pared for different geographic areas and among different ethnic groups, with an attempt to address how suspected risk factors for prostate cancer may relate to the observed global discrepancies with respect to inci- dence and mortality rates. The data provided in the first section pertain primarily, although not exclusively, to clinically evident prostate can- cer. As it is becoming increasingly recognized that prostatic neoplasia covers a wide biological spectrum, the second section reviews available epidemiological data on the early "phases" ofthe diseases, specifically precursor lesions and preinvasive neoplasia, and the category of pre- clinical or the so-called "latent" prostate cancer. Finally, the third sec- tion highlights some of the changes in the clinicopathological profile of prostate cancer diagnosed in the prostate-specific antigen (PSA) era of the 1990s: During the last decade, the Western Hemisphere in particular has witnessed significant changes in the profile of both the patients diagnosed with prostate cancer and the characteristics of their tumors. From: Current Clinical Urology: Prostate CancerScreening Edited by: I. M. Thompson, M. I. Resnick, and E. A. Klein © Humana Press Inc., Totowa, NJ 1