Presentation Authors: Kerri Beckmann, Netty Kinsella, London, United Kingdom, Henrik Olsen, Anna Wallerstedt-Lantz, Tobias Nordstrom, Markus Aly, Jan Adolfsson, Martin Eklund, Stockholm, Sweden, Mieke Van Hemelrijck*, London, United Kingdom
Introduction: It has been suggested that anxiety and concerns about cancer may influence both decisions to undergo PSA &[prime]screening&[prime] tests and choice of radical treatment over active surveillance (AS) for low risk prostate cancer (PCa). Our objective was to determine whether there is any association between prior history of PSA testing or experience of negative biopsy and uptake of AS among men diagnosed with low risk PCa.
Methods: This study included all men aged â‰¤75 years residing in Stockholm who were diagnosed with low risk PCa from 2008-2014. Data on dates and results of all PSA tests and any prostate biopsy procedures undertaken before diagnosis were obtained from the Stockholm PSA and Biopsy Register, a population-based register of all PSA and biopsy procedures since 2003 among men residing in Stockholm. Associations between PSA/biopsy measures (frequency of PSA testing, mean interval between tests, highest PSA value, PSA velocity and number of prior negative biopsies) and uptake of AS were assessed using multivariable logistic regression, with adjustment for age, education, martial status and comorbidity.
Results: Of the 4336 eligible men with low risk PCa, 47% underwent AS. Uptake of AS was more likely among men older men, those with very low risk disease, those with a family history of PCa and being diagnosed more recently. No association was found with frequency of PSA testing, interval between tests, highest total pre-diagnostic PSA concentration, PSA velocity or previous negative biopsy.
Conclusions: We found no evidence to suggest that PSA &[prime]screening&[prime] behavior or experience of a prior negative biopsy influenced uptake of AS among Swedish men. While availability of individual data on previous PSA tests and biopsy procedures is a major strength of this study, generalizability to settings with different policies and practices relating to PSA testing or PCa treatment may be limited.
Source of Funding: Swedish Cancer Society; NHMRC