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Accuracy of prostate biopsies for predicting Gleason score in radical prostatectomy specimens: nationwide trends 2000-2012.

https://arctichealth.org/en/permalink/ahliterature282854
Source
BJU Int. 2017 Jan;119(1):50-56
Publication Type
Article
Date
Jan-2017
Author
Daniela Danneman
Linda Drevin
Brett Delahunt
Hemamali Samaratunga
David Robinson
Ola Bratt
Stacy Loeb
Pär Stattin
Lars Egevad
Source
BJU Int. 2017 Jan;119(1):50-56
Date
Jan-2017
Language
English
Publication Type
Article
Keywords
Aged
Biopsy, Needle
Humans
Male
Neoplasm Grading - trends
Predictive value of tests
Prostate - pathology
Prostatectomy - methods
Prostatic Neoplasms - pathology - surgery
Reproducibility of Results
Sweden
Time Factors
Abstract
To investigate how well the Gleason score in diagnostic needle biopsies predicted the Gleason score in a subsequent radical prostatectomy (RP) specimen before and after the 2005 International Society of Urological Pathology (ISUP) revision of Gleason grading, and if the recently proposed ISUP grades 1-5 (corresponding to Gleason scores 6, 3 + 4, 4 + 3, 8 and 9-10) better predict the RP grade.
All prostate cancers diagnosed in Sweden are reported to the National Prostate Cancer Register (NPCR). We analysed the Gleason scores and ISUP grades from the diagnostic biopsies and the RP specimens in 15 598 men in the NPCR who: were diagnosed between 2000 and 2012 with clinical stage T1-2 M0/X prostate cancer on needle biopsy; were aged =70 years; had serum PSA concentration of
PubMed ID
26918298 View in PubMed
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Adherence to guidelines for androgen deprivation therapy after radical prostatectomy: Swedish population-based study.

https://arctichealth.org/en/permalink/ahliterature311023
Source
Scand J Urol. 2020 Jun; 54(3):208-214
Publication Type
Journal Article
Observational Study
Date
Jun-2020
Author
Magdalena Lycken
Linda Drevin
Hans Garmo
Anders Larsson
Ove Andrén
Lars Holmberg
Anna Bill-Axelson
Author Affiliation
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Source
Scand J Urol. 2020 Jun; 54(3):208-214
Date
Jun-2020
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Aged
Aged, 80 and over
Androgen Antagonists - therapeutic use
Combined Modality Therapy
Guideline Adherence - statistics & numerical data
Humans
Male
Middle Aged
Orchiectomy
Postoperative Period
Prostatectomy
Prostatic Neoplasms - drug therapy - surgery
Sweden
Abstract
Background: Androgen deprivation therapy (ADT) is a non-curative but essential treatment of prostate cancer with severe side effects. Therefore, both over- and underuse should be avoided. We investigated adherence to guidelines for ADT following radical prostatectomy through Swedish population-based data.Material and methods: We used the database Uppsala/Örebro PSA cohort (UPSAC) to study men with localised or locally advanced prostate cancer at diagnosis (clinical stage T1-T3, N0-NX, M0-MX, and prostate-specific antigen (PSA)
PubMed ID
32338176 View in PubMed
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Concordance of Non-Low-Risk Disease Among Pairs of Brothers With Prostate Cancer.

https://arctichealth.org/en/permalink/ahliterature302654
Source
J Clin Oncol. 2018 06 20; 36(18):1847-1852
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Twin Study
Date
06-20-2018
Author
Fredrik Jansson
Linda Drevin
Thomas Frisell
Pär Stattin
Ola Bratt
Olof Akre
Author Affiliation
Fredrik Jansson, Thomas Frisell, and Olof Akre, Karolinska Institute; Olof Akre, Karolinska University Hospital; Fredrik Jansson, Danderyd Hospital, Stockholm; Linda Drevin, Regional Cancer Centre, Uppsala/Örebro; Pär Stattin, Uppsala University Hospital, Uppsala; and Ola Bratt, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Source
J Clin Oncol. 2018 06 20; 36(18):1847-1852
Date
06-20-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Twin Study
Keywords
Aged
Cohort Studies
Humans
Male
Middle Aged
Neoplasm Staging
Odds Ratio
Prostatic Neoplasms - epidemiology - genetics - pathology
Registries
Risk
Siblings
Sweden - epidemiology
Twins, Monozygotic - genetics
Abstract
Purpose Prostate cancer among first-degree relatives is a strong risk factor for diagnosis of prostate cancer, and the contribution of heritable factors in prostate cancer etiology is high. We investigated how the concordance of non-low-risk prostate cancer among brothers is affected by their genetic relation. Methods We identified 4,262 pairs of brothers with prostate cancer in the Prostate Cancer Database Sweden. Their cancers were categorized as low risk (Gleason score = 6; clinical stage T1-2, Nx/N0, Mx/M0; and prostate-specific antigen = 10 ng/mL) or non-low risk. The odds ratio (OR) for concordance of non-low-risk cancer was calculated with logistic regression for the different types of fraternity (monozygotic twins, dizygotic twins, full brothers, and half-brothers) Results Among monozygotic twins who both were diagnosed with prostate cancer, the OR for both brothers being in the non-low-risk category was 3.82 (95% CI, 0.99 to 16.72) after adjusting for age and year of diagnosis. Among full brothers, the corresponding adjusted OR was 1.21 (95% CI, 1.04 to 1.39). When the analysis was restricted to brothers who both were diagnosed within 4 years, the results were similar. Conclusion Non-low-risk prostate cancer has a heritable pattern suggesting shared genetic factors, with the highest concordance among monozygotic twins. Our results suggest that a man whose brother has been diagnosed with a non-low-risk prostate cancer is at a clinically relevant increased risk of developing an aggressive prostate cancer himself.
PubMed ID
29652556 View in PubMed
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Family History and Probability of Prostate Cancer, Differentiated by Risk Category: A Nationwide Population-Based Study.

https://arctichealth.org/en/permalink/ahliterature283998
Source
J Natl Cancer Inst. 2016 Oct;108(10)
Publication Type
Article
Date
Oct-2016
Author
Ola Bratt
Linda Drevin
Olof Akre
Hans Garmo
Pär Stattin
Source
J Natl Cancer Inst. 2016 Oct;108(10)
Date
Oct-2016
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Confidence Intervals
Humans
Male
Neoplasm Grading
Probability
Prostatic Neoplasms - epidemiology - genetics - pathology
Risk assessment
Siblings
Sweden - epidemiology
Abstract
Familial prostate cancer risk estimates are inflated by clinically insignificant low-risk cancer, diagnosed after prostate-specific antigen testing. We provide age-specific probabilities of non-low- and high-risk prostate cancer.
Fifty-one thousand, eight hundred ninety-seven brothers of 32 807 men with prostate cancer were identified in Prostate Cancer data Base Sweden (PCBaSe). Nelson-Aalen estimates with 95% confidence intervals (CIs) were calculated for cumulative, family history-stratified probabilities of any, non-low- (any of Gleason score = 7, prostate-specific antigen [PSA] = 10?ng/mL, T3-4, N1, and/or M1) and high-risk prostate cancer (Gleason score = 8 and/or T3-4 and/or PSA = 20?ng/mL and/or N1 and/or M1).
The population probability of any prostate cancer was 4.8% (95% CI?=?4.8% to 4.9%) at age 65 years and 12.9% (95% CI?=?12.8% to 12.9%) at age 75 years, of non-low-risk prostate cancer 2.8% (95% CI?=?2.7% to 2.8%) at age 65 years and 8.9% (95% CI?=?8.8% to 8.9%) at age 75 years, and of high-risk prostate cancer 1.4% (95% CI?=?1.3% to 1.4%) at age 65 years and 5.2% (95% CI?=?5.1% to 5.2%) at age 75 years. For men with one affected brother, probabilities of any prostate cancer were 14.9% (95% CI?=?14.1% to 15.8%) at age 65 years and 30.3% (95% CI?=?29.3% to 31.3%) at age 75 years, of non-low-risk prostate cancer 7.3% (95% CI?=?6.7% to 7.9%) at age 65 years and 18.8% (95% CI?=?17.9% to 19.6%) at age 75 years, and of high-risk prostate cancer 3.0% (95% CI?=?2.6% to 3.4%) at age 65 years and 8.9% (95% CI?=?8.2% to 9.5%) at age 75 years. Probabilities were higher for men with a stronger family history. For example, men with two affected brothers had a 13.6% (95% CI?=?9.9% to 17.6 %) probability of high-risk cancer at age 75 years.
The age-specific probabilities of non-low- and high-risk cancer presented here are more informative than relative risks of any prostate cancer and more suitable to use for counseling men with a family history of prostate cancer.
PubMed ID
27400876 View in PubMed
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Fathering of dizygotic twins and risk of prostate cancer: nationwide, population-based case-control study.

https://arctichealth.org/en/permalink/ahliterature264463
Source
PLoS One. 2014;9(10):e110506
Publication Type
Article
Date
2014
Author
Sara Wirén
Linda Drevin
Olof Akre
David Robinson
Pär Stattin
Source
PLoS One. 2014;9(10):e110506
Date
2014
Language
English
Publication Type
Article
Keywords
Aged
Case-Control Studies
Fertility
Humans
Male
Prostatic Neoplasms - epidemiology - etiology
Risk
Sweden - epidemiology
Twins, Dizygotic
Abstract
An association between male fertility and risk of prostate cancer has been suggested, possibly through lower androgen levels in subfertile men. We evaluated male fertility in relation to risk of prostate cancer by assessing the frequency of fathering of dizygotic twins, a marker of high fertility, among cases of prostate cancer and controls.
We performed a case-control study in Prostate Cancer data Base Sweden (PCBaSe), a nationwide, population-based cohort. PCBaSe was linked to the Swedish twin register for information on zygosity for same-sex twins and to other nationwide health care registers and demographic databases for information on socioeconomic factors, comorbidity, and tumor characteristics for 96 301 prostate cancer cases and 378 583 matched controls. To account for the influence of in vitro fertilization on dizygotic twinning, analyses were restricted to men who had fathered children before 1991, when in vitro fertilization was still uncommon in Sweden.
1 112 cases and 4 538 controls had fathered dizygotic twins. Men with dizygotic twins had no increased risk of prostate cancer compared to fathers of singletons; neither for total prostate cancer odds ratio (OR) 0.95(95% CI 0.89-1.02), nor for any risk category, OR 0.97 (95% CI 0.84-1.12) for low-risk disease, and OR 1.04 (95% CI 0.90-1.22) for metastatic disease.
The lack of association between fathering of dizygotic twins and prostate cancer risk give no support for an association between male fertility and prostate cancer risk.
Notes
Cites: Methods Mol Biol. 2011;675:215-2020949391
Cites: J Natl Cancer Inst. 2007 Jan 3;99(1):77-8117202115
Cites: Hum Reprod. 2011 Aug;26(8):2247-5221669967
Cites: J Natl Cancer Inst. 2004 Jan 21;96(2):145-714734704
Cites: J Clin Endocrinol Metab. 2004 Jul;89(7):3161-715240588
Cites: Hum Reprod. 2004 Oct;19(10):2222-615298973
Cites: J Chronic Dis. 1987;40(5):373-833558716
Cites: Lancet. 1997 Mar 22;349(9055):843-59121260
Cites: Int J Cancer. 2005 Jul 20;115(6):994-715729731
Cites: Hum Reprod. 2007 Apr;22(4):1086-9017204529
Cites: J Natl Cancer Inst. 2007 Jun 6;99(11):901-2; author reply 903-417551156
Cites: Cancer. 2008 Feb 15;112(4):919-2318181100
Cites: Scand J Urol Nephrol. 2007;41(6):456-7717934985
Cites: Cancer Epidemiol Biomarkers Prev. 2008 Oct;17(10):2525-3018842992
Cites: Best Pract Res Clin Endocrinol Metab. 2008 Aug;22(4):601-1318971121
Cites: Urology. 2009 May;73(5 Suppl):S4-1019375626
Cites: Eur J Epidemiol. 2009;24(11):659-6719504049
Cites: Scand J Urol Nephrol. 2009;43(5):342-919921977
Cites: J Natl Compr Canc Netw. 2010 Feb;8(2):162-20020141676
Cites: Cancer. 2010 May 1;116(9):2140-720309846
Cites: Lancet Oncol. 2010 Aug;11(8):725-3220598634
Cites: Cancer Causes Control. 2010 Oct;21(10):1635-4320524053
Cites: BMC Public Health. 2011;11:45021658213
Cites: Twin Res Hum Genet. 2013 Feb;16(1):317-2923137839
Cites: World J Urol. 2003 Nov;21(5):341-514566423
Cites: Epidemiology. 2002 Jan;13(1):72-911805589
Cites: Hum Reprod. 2001 Jul;16(7):1518-2611425841
Cites: Hum Reprod. 2007 Mar;22(3):751-517135304
Cites: Int J Cancer. 2013 Aug 15;133(4):937-4323354735
Cites: Int J Cancer. 2006 Feb 1;118(3):786-7; author reply 78816114016
Cites: Int J Epidemiol. 2011 Apr;40(2):480-720959354
PubMed ID
25337702 View in PubMed
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Gleason inflation 1998-2011: a registry study of 97,168 men.

https://arctichealth.org/en/permalink/ahliterature261238
Source
BJU Int. 2015 Feb;115(2):248-55
Publication Type
Article
Date
Feb-2015
Author
Daniela Danneman
Linda Drevin
David Robinson
Pär Stattin
Lars Egevad
Source
BJU Int. 2015 Feb;115(2):248-55
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Humans
Logistic Models
Male
Neoplasm Grading
Neoplasm Recurrence, Local - mortality - pathology
Neoplasm Staging
Population Surveillance
Practice Guidelines as Topic
Prognosis
Prostate-Specific Antigen - blood
Prostatectomy - mortality - statistics & numerical data
Prostatic Neoplasms - blood - mortality - pathology
Registries
Sweden - epidemiology
Watchful Waiting
Abstract
To study long-term trends in Gleason grading in a nationwide population and to assess the impact of the International Society of Urological Pathology (ISUP) revision in 2005 of the Gleason system on grading practices, as in recent years there has been a shift upwards in Gleason grading of prostate cancer.
All newly diagnosed prostate cancers in Sweden are reported to the National Prostate Cancer Register (NPCR). In 97?168 men with a primary diagnosis of prostate cancer on needle biopsy from 1998 to 2011, Gleason score, clinical T stage (cT) and serum levels of prostate-specific antigen (s-PSA) at diagnosis were analysed.
Gleason score, cT stage and s-PSA were reported to the NPCR in 97%, 99% and 99% of cases. Before and after 2005, Gleason score 7-10 was diagnosed in 52% and 57%, respectively (P
PubMed ID
24552193 View in PubMed
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Nationwide population based study of infections after transrectal ultrasound guided prostate biopsy.

https://arctichealth.org/en/permalink/ahliterature258848
Source
J Urol. 2014 Oct;192(4):1116-22
Publication Type
Article
Date
Oct-2014
Author
Karl-Johan Lundström
Linda Drevin
Stefan Carlsson
Hans Garmo
Stacy Loeb
Pär Stattin
Anna Bill-Axelson
Source
J Urol. 2014 Oct;192(4):1116-22
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Aged
Cause of Death
Endoscopic Ultrasound-Guided Fine Needle Aspiration - methods - mortality
Endosonography - methods
Follow-Up Studies
Humans
Male
Prostate - pathology
Prostatic Neoplasms - mortality - pathology
Rectum
Reproducibility of Results
Retrospective Studies
Risk factors
Survival Rate - trends
Sweden - epidemiology
Abstract
Transrectal ultrasound guided biopsy is the gold standard for detecting prostate cancer but international reports suggest that increasing risks are associated with the procedure. We estimated incidence and risk factors for infection after prostate biopsy as well as 90-day mortality using a nationwide Swedish sample.
We performed a population based study of 51,321 men from PCBaSe between 2006 and 2011. Primary outcome measures were dispensed prescriptions of antibiotics for urinary tract infection and hospitalization with a discharge diagnosis of urinary tract infection. Multivariable logistic regression was used to examine risk factors for infection in men who underwent prostate biopsy.
During the 6 months before biopsy the background incidence of urinary tract infection was approximately 2%. Within 30 days after biopsy 6% of the men had a dispensed prescription for urinary tract antibiotics and 1% were hospitalized with infection. The strongest risk factors for an antibiotic prescription were prior infection (OR 1.59, 95% CI 1.45-1.73), high Charlson comorbidity index (OR 1.25, 95% CI 1.11-1.41) and diabetes (OR 1.32, 95% CI 1.17-1.49). Risk of an antibiotic prescription after biopsy decreased from 2006 to 2011 (OR 0.79, 95% CI 0.70-0.90) but the risk of hospital admission increased (OR 2.14, 95% CI 1.58-2.94). No significant increase was observed in 90-day mortality.
Severe infections with hospitalization after prostate biopsy are increasing in Sweden. The risk of post-biopsy infection is highest in men with a history of urinary tract infection and those with significant comorbidities.
PubMed ID
24813343 View in PubMed
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Primary cancers before and after prostate cancer diagnosis.

https://arctichealth.org/en/permalink/ahliterature123711
Source
Cancer. 2012 Dec 15;118(24):6207-16
Publication Type
Article
Date
Dec-15-2012
Author
Mieke Van Hemelrijck
Linda Drevin
Lars Holmberg
Hans Garmo
Jan Adolfsson
Pär Stattin
Author Affiliation
Cancer Epidemiology Group, Division of Cancer Studies, School of Medicine, King's College London, London, United Kingdom. mieke.vanhemelrijck@kcl.ac.uk
Source
Cancer. 2012 Dec 15;118(24):6207-16
Date
Dec-15-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Follow-Up Studies
Humans
Incidence
Male
Neoplasm Staging
Neoplasms, Second Primary - epidemiology - therapy
Prognosis
Prostatic Neoplasms - diagnosis - etiology - therapy
Registries
Risk factors
Sweden
Abstract
The occurrence of multiple cancers may indicate common etiology; and, although some studies have investigated the risk of second primary cancers after prostate cancer (PCa), there are no studies on cancers before PCa.
The PCBaSe Sweden database is based on the National Prostate Cancer Register (NPCR), which covers >96% of PCa cases. The authors estimated the prevalence and cumulative incidence of different cancers before and after PCa diagnosis in 72,613 men according to PCa treatment and disease stage in PCBaSe and their matched comparison cohort of men who were free of PCa.
In total, 6829 men were diagnosed with another primary cancer before their PCa diagnosis, including 138 men at the time of PCa diagnosis and 5230 men were diagnosed after PCa diagnosis. Cancer of the bladder or colon and nonmelanoma of the skin were the 3 most frequently observed cancers before and after PCa diagnosis. At the time of PCa diagnosis, the prevalence of these 3 cancers was 1.94% for bladder cancer, 1.08% for colon cancer, and 1.08% for nonmelanoma skin cancer, compared with 1.30%, 0.96%, and 1.03%, respectively, for the matched comparison cohort. Five years after PCa diagnosis, the difference in incidence proportion between PCa men and their comparison cohort was 7 ‰ (95% CI, 5.6 ‰-8.5 ‰), 1.3 ‰ (0 ‰-2.6 ‰), and 1.6 ‰ (0.6 ‰-2.6 ‰) for these 3 cancers, respectively. From a uro-oncologic point of view, it is interesting to note that the prevalence of kidney cancer at the time of PCa diagnosis was 0.42% compared with 0.28% for the matched comparison cohort.
Approximately 17% of all PCa occurred in combination with another primary cancer (before or after PCa diagnosis). Detection bias probably explains part of this observation, but further investigations are required to assess possible underlying mechanisms.
PubMed ID
22674346 View in PubMed
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Prostate cancer imaging trends after a nationwide effort to discourage inappropriate prostate cancer imaging.

https://arctichealth.org/en/permalink/ahliterature108713
Source
J Natl Cancer Inst. 2013 Sep 4;105(17):1306-13
Publication Type
Article
Date
Sep-4-2013
Author
Danil V Makarov
Stacy Loeb
David Ulmert
Linda Drevin
Mats Lambe
Pär Stattin
Author Affiliation
US Department of Veterans Affairs, New York University, New York, NY, USA.
Source
J Natl Cancer Inst. 2013 Sep 4;105(17):1306-13
Date
Sep-4-2013
Language
English
Publication Type
Article
Keywords
Aged
Early Detection of Cancer - methods - statistics & numerical data - trends - utilization
Health Resources - utilization
Humans
Linear Models
Male
Middle Aged
Neoplasm Grading
Neoplasm Staging
Prostate-Specific Antigen - blood
Prostatic Neoplasms - diagnosis - immunology - pathology
Retrospective Studies
Risk assessment
Sweden - epidemiology
Tumor Markers, Biological - blood
Unnecessary Procedures - statistics & numerical data
Abstract
Reducing inappropriate use of imaging to stage incident prostate cancer is a challenging problem highlighted recently as a Physician Quality Reporting System quality measure and by the American Society of Clinical Oncology and the American Urological Association in the Choosing Wisely campaign. Since 2000, the National Prostate Cancer Register (NPCR) of Sweden has led an effort to decrease national rates of inappropriate prostate cancer imaging by disseminating utilization data along with the latest imaging guidelines to urologists in Sweden. We sought to determine the temporal and regional effects of this effort on prostate cancer imaging rates.
We performed a retrospective cohort study among men diagnosed with prostate cancer from the NPCR from 1998 to 2009 (n = 99 879). We analyzed imaging use over time stratified by clinical risk category (low, intermediate, high) and geographic region. Generalized linear models with a logit link were used to test for time trend.
Thirty-six percent of men underwent imaging within 6 months of prostate cancer diagnosis. Overall, imaging use decreased over time, particularly in the low-risk category, among whom the imaging rate decreased from 45% to 3% (P
Notes
Cites: Eur Urol. 2001 Aug;40(2):97-10111528184
Cites: Br J Urol. 1995 Jun;75(6):778-817542138
Cites: J Urol. 2011 May;185(5):1645-921419444
Cites: J Urol. 2011 Sep;186(3):844-921788043
Cites: J Urol. 2012 Jan;187(1):97-10222088337
Cites: Health Aff (Millwood). 2012 Apr;31(4):730-4022492890
Cites: JAMA. 2012 May 2;307(17):1801-222492759
Cites: J Clin Oncol. 2012 May 10;30(14):1715-2422493340
Cites: Ann Intern Med. 2012 Oct 16;157(8):574-622928172
Cites: Int J Epidemiol. 2013 Aug;42(4):956-6722561842
Cites: Urol Clin North Am. 2001 Aug;28(3):555-6511590814
Cites: Urology. 2011 Feb;77(2):274-820932557
Cites: J Urol. 1991 May;145(5):907-231707989
Cites: J Urol. 2010 Dec;184(6):2485-9020961582
Cites: J Am Coll Cardiol. 2008 Feb 19;51(7):716-2318279735
Cites: J Urol. 2007 Jul;178(1):82-7; discussion 8717499294
Cites: Phys Ther. 1999 Apr;79(4):384-9610201544
Cites: J Urol. 1998 Dec;160(6 Pt 1):2102-69817332
Cites: Acad Radiol. 1998 Sep;5 Suppl 2:S315-69750842
Cites: J Urol. 1997 Sep;158(3 Pt 1):687-989258062
Cites: Scand J Work Environ Health. 2000 Aug;26(4):363-710994804
Cites: Urology. 2002 Mar;59(3):400-411880080
Cites: J Urol. 2002 Aug;168(2):491-512131295
Cites: Urology. 2002 Nov;60(5):756-912429290
Cites: J Clin Oncol. 2004 Jun 1;22(11):2141-915169800
Cites: J Urol. 1991 Feb;145(2):313-81703240
Comment In: J Urol. 2014 May;191(5):128724745487
Comment In: J Urol. 2014 May;191(5):1287-824745486
PubMed ID
23853055 View in PubMed
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Prostate cancer in kidney transplant recipients - a nationwide register study.

https://arctichealth.org/en/permalink/ahliterature307248
Source
BJU Int. 2020 05; 125(5):679-685
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Date
05-2020
Author
Ola Bratt
Linda Drevin
Karl-Göran Prütz
Stefan Carlsson
Lars Wennberg
Pär Stattin
Author Affiliation
Department of Urology, Institute of Clinical Science, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
Source
BJU Int. 2020 05; 125(5):679-685
Date
05-2020
Language
English
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Keywords
Graft Rejection - prevention & control
Humans
Immunosuppression - adverse effects
Immunosuppressive Agents - adverse effects
Incidence
Kidney Transplantation
Male
Middle Aged
Population Surveillance - methods
Propensity Score
Prostatic Neoplasms - diagnosis - epidemiology
Registries
Retrospective Studies
Risk factors
Survival Rate - trends
Sweden - epidemiology
Transplant Recipients
Abstract
To investigate whether post-transplantation immunosuppression negatively affects prostate cancer outcomes in male kidney transplant recipients.
We used the Swedish Renal Register and the National Prostate Cancer Register to identify all kidney transplantation recipients diagnosed with prostate cancer in Sweden 1998-2016. After linking these registers with Prostate Cancer Database Sweden (PCBaSe), a case-control study was designed to compare time period and risk category-specific probabilities of a prostate cancer diagnosis amongst kidney transplantation recipients versus the male general population. The registers did not include information about the specific immunosuppression agent used in all transplantation recipients. Data from PCBaSe were used to compare prostate cancer characteristics at diagnosis and survival for patients with prostate cancer with versus without a kidney transplant. Propensity score matching, Cox regression analysis and Fisher's exact test were used and 95% confidence intervals (CIs) calculated.
Almost half of the 133 kidney transplantation recipients were transplanted before the mid-1990s, when PSA testing became common. The transplant recipients were not more likely than age-matched control men to be diagnosed with any (odds ratio [OR] 0.84, 95% CI 0.70-0.99) or high-risk or metastatic prostate cancer (OR 0.84, 95% CI 0.62-1.13). None of the ORs for the different categories of prostate cancer increased with time since transplantation. Cancer characteristics at the time of diagnosis and cancer-specific survival were similar amongst transplant recipients and the control group of 665 men diagnosed with prostate cancer without a kidney transplant.
This Swedish nationwide, register-based study gave no indication that immunosuppression after kidney transplantation increases the risk of prostate cancer or adversely affects prostate cancer outcomes. The study suggests that men with untreated low-grade prostate cancer can be accepted for transplantation.
Notes
CommentIn: BJU Int. 2020 May;125(5):628-629 PMID 32349188
PubMed ID
31955497 View in PubMed
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14 records – page 1 of 2.