2014 Volume 2 Issue 1 Pages 27-34
Objective: To investigate clinicopathological features and define factors predicting survival in patients diagnosed with prostate cancer by the two major Japanese screening systems.
Methods: Between 1999 and 2010, 36 (10.4%) and 310 (89.6%) patients were diagnosed with prostate cancer in Ningen Dock and population-based screening, respectively. Clinicopathological features were recorded and factors predictive of biochemical relapse-free survival (bRFS), cause-specific survival, and overall survival were investigated.
Results: The mean ages of patients detected in Ningen Dock and population-based screening were 63 and 73 years, respectively. The proportion of localized prostate cancer was higher, with borderline statistical significance, in Ningen Dock, and significantly higher in those who had been screened at least once prior to diagnosis, compared with patients diagnosed in population-based screening, and those who had not been screened prior to diagnosis. The bRFS was significantly lower in patients who were older than the median age, in those diagnosed in population-based screening, in those with PSA above the median value, in patients at advanced clinical stages, in those with poorer Gleason scores, and in patients for whom the proportion of positive biopsy cores was > 25%. In the multivariate Cox’s proportional hazards model, only clinical stage and age were significant independent prognostic factors predicting bRFS.
Conclusions: In Japan, the Ningen Dock and population-based screening systems provide complementary cover for males of different ages. Both screening systems play important roles in Japan in detecting prostate cancer at the curative stage, and improving patient outcomes.
