Authors' recommendations: Prostate cancer is the most commonly diagnosed cancer in men and the second most common cause of cancer-related deaths in men in the United States. The risk to develop prostate cancer is 1 in 7964 from birth to age 39, and 1 in 8 by age 70 and older. The natural history of prostate cancer is variable and difficult to predict. Survival differs according to disease stage at diagnosis. Approximately 93% of prostate cancers are discovered in the local or regional stages, for which the 5-year relative survival rate approaches 100%. Malignant prostate cancer that has spread to parts of the body remote to the primary tumor either by direct extension or by continuous metastasis has a 5-year survival rate of 28%. Early prostate cancer at the local or regional stages usually has no symptoms. With more advanced disease, men may experience weak or interrupted urine flow; the inability to urinate or difficulty starting or stopping the urine flow; the need to urinate frequently, especially at night; blood in the urine; or pain or burning with urination. Various screening options are available for early detection of prostate cancer in the United States, such as the prostatespecific antigen (PSA) test, the digital rectal exam (DRE), and transrectal ultrasound (TRUS). The disease staging system used in prostate cancer is complex and based upon evaluation of 3 characteristics: extent of the primary tumor (T); presence or absence of lymph node involvement (N); and distant metastasis (M). The Gleason score is also used in staging of prostate cancer, a score assigned to a tumor biopsy sample by a pathologist based upon its microscopic appearance. As a result of widespread screening options, most patients are diagnosed with asymptomatic, clinically localized cancer. The choice of initial treatment is also influenced by estimated life expectancy, comorbidities, and potential therapy side effects. The primary management options for initial therapy for localized prostate cancer include active surveillance, radiation therapy, or radical prostatectomy. The goal of developing screening tests and staging guidelines is to stratify patients into categories associated with prediction of disease outcome. The American Urological Association (AUA) risk stratification scheme categorizes patients into 3 groups: low-risk, intermediate-risk, and high-risk. The risk category for each patient is calculated based on PSA level, Gleason score, and tumor staging. Based on the risk level attributed to the patient, different treatment options can be recommended. Similarly, the Cancer of the Prostate Risk Assessment (CAPRA) score is calculated by considering the patient's PSA level, Gleason score, clinical tumor stage, and age at diagnosis; and gives a score result on a 0-to-10 scale, with a lower number corresponding to a lower risk. The Prolaris assay is an RNA expression assay that was developed to provide direct information about prostate tumor aggressiveness that is intended to inform management decisions.

Project Status: Completed

Year Published: 2013

URL for published report: The report may be purchased from: http://www.hayesinc.com/hayes/crd/?crd=15858

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: HAYES, Inc.

Contact Address: 157 S. Broad Street, Suite 200, Lansdale, PA 19446, USA. Tel: 215 855 0615; Fax: 215 855 5218

Contact Name: saleinfo@hayesinc.com

Contact Email: saleinfo@hayesinc.com

Copyright: 2013 Winifred S. Hayes, Inc