Unscreened older men diagnosed with prostate cancer are at increased risk of aggressive disease
Background: To evaluate the relationship between PSA testing history and high-risk disease among older men diagnosed with prostate cancer. Methods: Records from 1993 to 2014 were reviewed for men who underwent radiotherapy for prostate cancer at age 75 years or older. Patients were classified into o...
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| Veröffentlicht in: | Prostate cancer and prostatic diseases 2017-06, Vol.20 (2), p.193-196 |
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| creator | Tosoian, J J Alam, R Gergis, C Narang, A Radwan, N Robertson, S McNutt, T Ross, A E Song, D Y DeWeese, T L Tran, P T Walsh, P C |
| description | Background:
To evaluate the relationship between PSA testing history and high-risk disease among older men diagnosed with prostate cancer.
Methods:
Records from 1993 to 2014 were reviewed for men who underwent radiotherapy for prostate cancer at age 75 years or older. Patients were classified into one of four groups based on PSA-testing history: (1) no PSA testing; (2) incomplete/ineffective PSA testing; (3) PSA testing; or (4) cannot be determined. Outcomes of interest were National Comprehensive Cancer Network (NCCN) risk group (that is, low, intermediate or high risk) and biopsy grade at diagnosis. Multivariable logistic regression was used to determine the association between PSA testing history and high-risk cancer.
Results:
PSA-testing history was available in 274 (94.5%) of 290 subjects meeting study criteria. In total, 148 men (54.0%) underwent PSA testing with follow-up biopsy, 72 (26.3%) underwent PSA testing without appropriate follow-up, and 54 men (19.7%) did not undergo PSA testing. Patients who underwent PSA testing were significantly less likely to be diagnosed with NCCN high-risk cancer (23.0% vs 51.6%,
P |
| doi_str_mv | 10.1038/pcan.2016.64 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5429182</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A491539624</galeid><sourcerecordid>A491539624</sourcerecordid><originalsourceid>FETCH-LOGICAL-c609t-962c137a00945455b7c78fb149e0e1298d0cd80ff5358bdc866726f0d85a84e03</originalsourceid><addsrcrecordid>eNp9kstv1DAQhyMEoqVw44wiISEOZPE79qVSVfGSKnGhZ8vrTLIuWXuxkyL-eybaUnZRhXywNfPNbx6eqnpJyYoSrt_vvIsrRqhaKfGoOqWiVY1URD_GN1eyabVkJ9WzUm4IIYYa8rQ6YZoISSk_rex1LD4DROjqNHaQ6y3EugtuiKmg7WeYNvUupzK5CWpM5RFxGWo31SFipFuoHMr3OvW1G4YMpYRbQImy-J5XT3o3Fnhxd59V1x8_fLv83Fx9_fTl8uKq8YqYqTGKecpbhxUKKaRct77V_ZoKAwQoM7ojvtOk7yWXet15rVTLVE86LZ0WQPhZdb7X3c3rLXQe4pTdaHc5bF3-ZZML9tgTw8YO6dZKwQzVDAXe3gnk9GOGMtltKB7G0UVIc7E4ONoKTqhG9PU_6E2ac8T2LFNUSmYMI_-jqDat5twI9Zca3Ag2xD5hdX5JbS-EoZLjZARSqwcoPB1sg08R-oD2o4A3BwEbcOO0KWmcp5BiOQbf7UGPf1wy9Pcjo8Qu-2WX_bLLflm14K8Ox3wP_1koBJo9UNAVB8gHXT8k-BvVYtga</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1897833946</pqid></control><display><type>article</type><title>Unscreened older men diagnosed with prostate cancer are at increased risk of aggressive disease</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Tosoian, J J ; Alam, R ; Gergis, C ; Narang, A ; Radwan, N ; Robertson, S ; McNutt, T ; Ross, A E ; Song, D Y ; DeWeese, T L ; Tran, P T ; Walsh, P C</creator><creatorcontrib>Tosoian, J J ; Alam, R ; Gergis, C ; Narang, A ; Radwan, N ; Robertson, S ; McNutt, T ; Ross, A E ; Song, D Y ; DeWeese, T L ; Tran, P T ; Walsh, P C</creatorcontrib><description>Background:
To evaluate the relationship between PSA testing history and high-risk disease among older men diagnosed with prostate cancer.
Methods:
Records from 1993 to 2014 were reviewed for men who underwent radiotherapy for prostate cancer at age 75 years or older. Patients were classified into one of four groups based on PSA-testing history: (1) no PSA testing; (2) incomplete/ineffective PSA testing; (3) PSA testing; or (4) cannot be determined. Outcomes of interest were National Comprehensive Cancer Network (NCCN) risk group (that is, low, intermediate or high risk) and biopsy grade at diagnosis. Multivariable logistic regression was used to determine the association between PSA testing history and high-risk cancer.
Results:
PSA-testing history was available in 274 (94.5%) of 290 subjects meeting study criteria. In total, 148 men (54.0%) underwent PSA testing with follow-up biopsy, 72 (26.3%) underwent PSA testing without appropriate follow-up, and 54 men (19.7%) did not undergo PSA testing. Patients who underwent PSA testing were significantly less likely to be diagnosed with NCCN high-risk cancer (23.0% vs 51.6%,
P
<0.001). On multivariable analysis, men with no/incomplete PSA testing had more than three-fold increased odds of high-risk disease at diagnosis (odds ratio 3.39, 95% confidence interval 1.96–5.87,
P
<0.001) as compared to the tested population.
Conclusions:
Older men who underwent no PSA testing or incomplete testing were significantly more likely to be diagnosed with high-risk prostate cancer than those who were previously screened. It is reasonable to consider screening in healthy older men likely to benefit from early detection and treatment.</description><identifier>ISSN: 1365-7852</identifier><identifier>EISSN: 1476-5608</identifier><identifier>DOI: 10.1038/pcan.2016.64</identifier><identifier>PMID: 28045113</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/67/2322 ; 631/67/589/466 ; 692/699/67/2322 ; 692/699/67/589/466 ; Age Factors ; Aged ; Aged, 80 and over ; Biomedical and Life Sciences ; Biomedicine ; Biopsy ; Cancer Research ; Confidence intervals ; Diagnosis ; Early Detection of Cancer ; Health risks ; Health screening ; Humans ; Logistic Models ; Male ; original-article ; Patients ; Prostate - pathology ; Prostate cancer ; Prostate-Specific Antigen - blood ; Prostatic Neoplasms - blood ; Prostatic Neoplasms - epidemiology ; Prostatic Neoplasms - pathology ; Radiation therapy ; Radiotherapy ; Risk ; Risk Assessment ; Risk Factors ; Statistical analysis</subject><ispartof>Prostate cancer and prostatic diseases, 2017-06, Vol.20 (2), p.193-196</ispartof><rights>Macmillan Publishers Limited, part of Springer Nature. 2017</rights><rights>COPYRIGHT 2017 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Jun 2017</rights><rights>Macmillan Publishers Limited, part of Springer Nature. 2017.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c609t-962c137a00945455b7c78fb149e0e1298d0cd80ff5358bdc866726f0d85a84e03</citedby><cites>FETCH-LOGICAL-c609t-962c137a00945455b7c78fb149e0e1298d0cd80ff5358bdc866726f0d85a84e03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/pcan.2016.64$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/pcan.2016.64$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,778,782,883,27907,27908,41471,42540,51302</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28045113$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tosoian, J J</creatorcontrib><creatorcontrib>Alam, R</creatorcontrib><creatorcontrib>Gergis, C</creatorcontrib><creatorcontrib>Narang, A</creatorcontrib><creatorcontrib>Radwan, N</creatorcontrib><creatorcontrib>Robertson, S</creatorcontrib><creatorcontrib>McNutt, T</creatorcontrib><creatorcontrib>Ross, A E</creatorcontrib><creatorcontrib>Song, D Y</creatorcontrib><creatorcontrib>DeWeese, T L</creatorcontrib><creatorcontrib>Tran, P T</creatorcontrib><creatorcontrib>Walsh, P C</creatorcontrib><title>Unscreened older men diagnosed with prostate cancer are at increased risk of aggressive disease</title><title>Prostate cancer and prostatic diseases</title><addtitle>Prostate Cancer Prostatic Dis</addtitle><addtitle>Prostate Cancer Prostatic Dis</addtitle><description>Background:
To evaluate the relationship between PSA testing history and high-risk disease among older men diagnosed with prostate cancer.
Methods:
Records from 1993 to 2014 were reviewed for men who underwent radiotherapy for prostate cancer at age 75 years or older. Patients were classified into one of four groups based on PSA-testing history: (1) no PSA testing; (2) incomplete/ineffective PSA testing; (3) PSA testing; or (4) cannot be determined. Outcomes of interest were National Comprehensive Cancer Network (NCCN) risk group (that is, low, intermediate or high risk) and biopsy grade at diagnosis. Multivariable logistic regression was used to determine the association between PSA testing history and high-risk cancer.
Results:
PSA-testing history was available in 274 (94.5%) of 290 subjects meeting study criteria. In total, 148 men (54.0%) underwent PSA testing with follow-up biopsy, 72 (26.3%) underwent PSA testing without appropriate follow-up, and 54 men (19.7%) did not undergo PSA testing. Patients who underwent PSA testing were significantly less likely to be diagnosed with NCCN high-risk cancer (23.0% vs 51.6%,
P
<0.001). On multivariable analysis, men with no/incomplete PSA testing had more than three-fold increased odds of high-risk disease at diagnosis (odds ratio 3.39, 95% confidence interval 1.96–5.87,
P
<0.001) as compared to the tested population.
Conclusions:
Older men who underwent no PSA testing or incomplete testing were significantly more likely to be diagnosed with high-risk prostate cancer than those who were previously screened. It is reasonable to consider screening in healthy older men likely to benefit from early detection and treatment.</description><subject>631/67/2322</subject><subject>631/67/589/466</subject><subject>692/699/67/2322</subject><subject>692/699/67/589/466</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Biopsy</subject><subject>Cancer Research</subject><subject>Confidence intervals</subject><subject>Diagnosis</subject><subject>Early Detection of Cancer</subject><subject>Health risks</subject><subject>Health screening</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>original-article</subject><subject>Patients</subject><subject>Prostate - pathology</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatic Neoplasms - blood</subject><subject>Prostatic Neoplasms - epidemiology</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Risk</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Statistical analysis</subject><issn>1365-7852</issn><issn>1476-5608</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kstv1DAQhyMEoqVw44wiISEOZPE79qVSVfGSKnGhZ8vrTLIuWXuxkyL-eybaUnZRhXywNfPNbx6eqnpJyYoSrt_vvIsrRqhaKfGoOqWiVY1URD_GN1eyabVkJ9WzUm4IIYYa8rQ6YZoISSk_rex1LD4DROjqNHaQ6y3EugtuiKmg7WeYNvUupzK5CWpM5RFxGWo31SFipFuoHMr3OvW1G4YMpYRbQImy-J5XT3o3Fnhxd59V1x8_fLv83Fx9_fTl8uKq8YqYqTGKecpbhxUKKaRct77V_ZoKAwQoM7ojvtOk7yWXet15rVTLVE86LZ0WQPhZdb7X3c3rLXQe4pTdaHc5bF3-ZZML9tgTw8YO6dZKwQzVDAXe3gnk9GOGMtltKB7G0UVIc7E4ONoKTqhG9PU_6E2ac8T2LFNUSmYMI_-jqDat5twI9Zca3Ag2xD5hdX5JbS-EoZLjZARSqwcoPB1sg08R-oD2o4A3BwEbcOO0KWmcp5BiOQbf7UGPf1wy9Pcjo8Qu-2WX_bLLflm14K8Ox3wP_1koBJo9UNAVB8gHXT8k-BvVYtga</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Tosoian, J J</creator><creator>Alam, R</creator><creator>Gergis, C</creator><creator>Narang, A</creator><creator>Radwan, N</creator><creator>Robertson, S</creator><creator>McNutt, T</creator><creator>Ross, A E</creator><creator>Song, D Y</creator><creator>DeWeese, T L</creator><creator>Tran, P T</creator><creator>Walsh, P C</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7QO</scope><scope>5PM</scope></search><sort><creationdate>20170601</creationdate><title>Unscreened older men diagnosed with prostate cancer are at increased risk of aggressive disease</title><author>Tosoian, J J ; Alam, R ; Gergis, C ; Narang, A ; Radwan, N ; Robertson, S ; McNutt, T ; Ross, A E ; Song, D Y ; DeWeese, T L ; Tran, P T ; Walsh, P C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c609t-962c137a00945455b7c78fb149e0e1298d0cd80ff5358bdc866726f0d85a84e03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>631/67/2322</topic><topic>631/67/589/466</topic><topic>692/699/67/2322</topic><topic>692/699/67/589/466</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Biopsy</topic><topic>Cancer Research</topic><topic>Confidence intervals</topic><topic>Diagnosis</topic><topic>Early Detection of Cancer</topic><topic>Health risks</topic><topic>Health screening</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>original-article</topic><topic>Patients</topic><topic>Prostate - pathology</topic><topic>Prostate cancer</topic><topic>Prostate-Specific Antigen - blood</topic><topic>Prostatic Neoplasms - blood</topic><topic>Prostatic Neoplasms - epidemiology</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Risk</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Statistical analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tosoian, J J</creatorcontrib><creatorcontrib>Alam, R</creatorcontrib><creatorcontrib>Gergis, C</creatorcontrib><creatorcontrib>Narang, A</creatorcontrib><creatorcontrib>Radwan, N</creatorcontrib><creatorcontrib>Robertson, S</creatorcontrib><creatorcontrib>McNutt, T</creatorcontrib><creatorcontrib>Ross, A E</creatorcontrib><creatorcontrib>Song, D Y</creatorcontrib><creatorcontrib>DeWeese, T L</creatorcontrib><creatorcontrib>Tran, P T</creatorcontrib><creatorcontrib>Walsh, P C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Biotechnology Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Prostate cancer and prostatic diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tosoian, J J</au><au>Alam, R</au><au>Gergis, C</au><au>Narang, A</au><au>Radwan, N</au><au>Robertson, S</au><au>McNutt, T</au><au>Ross, A E</au><au>Song, D Y</au><au>DeWeese, T L</au><au>Tran, P T</au><au>Walsh, P C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unscreened older men diagnosed with prostate cancer are at increased risk of aggressive disease</atitle><jtitle>Prostate cancer and prostatic diseases</jtitle><stitle>Prostate Cancer Prostatic Dis</stitle><addtitle>Prostate Cancer Prostatic Dis</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>20</volume><issue>2</issue><spage>193</spage><epage>196</epage><pages>193-196</pages><issn>1365-7852</issn><eissn>1476-5608</eissn><abstract>Background:
To evaluate the relationship between PSA testing history and high-risk disease among older men diagnosed with prostate cancer.
Methods:
Records from 1993 to 2014 were reviewed for men who underwent radiotherapy for prostate cancer at age 75 years or older. Patients were classified into one of four groups based on PSA-testing history: (1) no PSA testing; (2) incomplete/ineffective PSA testing; (3) PSA testing; or (4) cannot be determined. Outcomes of interest were National Comprehensive Cancer Network (NCCN) risk group (that is, low, intermediate or high risk) and biopsy grade at diagnosis. Multivariable logistic regression was used to determine the association between PSA testing history and high-risk cancer.
Results:
PSA-testing history was available in 274 (94.5%) of 290 subjects meeting study criteria. In total, 148 men (54.0%) underwent PSA testing with follow-up biopsy, 72 (26.3%) underwent PSA testing without appropriate follow-up, and 54 men (19.7%) did not undergo PSA testing. Patients who underwent PSA testing were significantly less likely to be diagnosed with NCCN high-risk cancer (23.0% vs 51.6%,
P
<0.001). On multivariable analysis, men with no/incomplete PSA testing had more than three-fold increased odds of high-risk disease at diagnosis (odds ratio 3.39, 95% confidence interval 1.96–5.87,
P
<0.001) as compared to the tested population.
Conclusions:
Older men who underwent no PSA testing or incomplete testing were significantly more likely to be diagnosed with high-risk prostate cancer than those who were previously screened. It is reasonable to consider screening in healthy older men likely to benefit from early detection and treatment.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>28045113</pmid><doi>10.1038/pcan.2016.64</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Prostate cancer and prostatic diseases, 2017-06, Vol.20 (2), p.193-196 |
| issn | 1365-7852 1476-5608 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | 631/67/2322 631/67/589/466 692/699/67/2322 692/699/67/589/466 Age Factors Aged Aged, 80 and over Biomedical and Life Sciences Biomedicine Biopsy Cancer Research Confidence intervals Diagnosis Early Detection of Cancer Health risks Health screening Humans Logistic Models Male original-article Patients Prostate - pathology Prostate cancer Prostate-Specific Antigen - blood Prostatic Neoplasms - blood Prostatic Neoplasms - epidemiology Prostatic Neoplasms - pathology Radiation therapy Radiotherapy Risk Risk Assessment Risk Factors Statistical analysis |
| title | Unscreened older men diagnosed with prostate cancer are at increased risk of aggressive disease |
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