Clinical features of prostate cancer before diagnosis: a population-based, case-control study

Even in areas where screening is available, many prostate cancers are diagnosed after the symptoms begin. However, the risk posed by particular symptoms is largely unknown, especially in unselected populations such as primary care. To identify and quantify the features of prostate cancer before diag...

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Bibliographic Details
Published in:British journal of general practice 2006-10, Vol.56 (531), p.756-762
Main Authors: Hamilton, William, Sharp, Deborah J, Peters, Tim J, Round, Alison P
Format: Article
Language:English
Subjects:
Adult
Aged
Case-Control Studies
Digital Rectal Examination
Early Diagnosis
Erectile Dysfunction - complications
Family Practice
Humans
Male
Middle Aged
Multivariate Analysis
Original Papers
Predictive Value of Tests
Prostate-Specific Antigen - blood
Prostatic Neoplasms - complications
Prostatic Neoplasms - diagnosis
Prostatism - complications
Referral and Consultation
Weight Loss
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Summary:Even in areas where screening is available, many prostate cancers are diagnosed after the symptoms begin. However, the risk posed by particular symptoms is largely unknown, especially in unselected populations such as primary care. To identify and quantify the features of prostate cancer before diagnosis, both individually and in combination. Population-based case-control study. All 21 general practices in Exeter, Devon, UK. We studied all 217 prostate cancer patients diagnosed between 1998 and 2002, and 1080 male controls, matched by age and general practice. The full medical record for 2 years before diagnosis was coded, using the International Classification of Primary Care. We calculated odds ratios for variables independently associated with cancer, using conditional logistic regression, and calculated the positive predictive values for these, both individually and in combination. Eight features were associated with prostate cancer before diagnosis. Their positive predictive values against a background risk of 0.35% were: urinary retention 3.1% (95% confidence interval [CI] = 1.5 to 6.0); impotence 3.0% (95% CI = 1.7 to 4.9); frequency 2.2% (95% CI = 1.3 to 3.5); hesitancy 3.0% (95% CI = 1.5 to 5.5); nocturia 2.2% (95% CI = 1.2 to 3.6); haematuria 1.0% (95% CI = 0.57 to 1.8); weight loss 0.75% (95% CI = 0.38 to 1.4); abnormal rectal examination, deemed benign 2.8% (95% CI = 1.6 to 4.6); abnormal rectal examination, deemed malignant 12% (95% CI = 5.0 to 37): all P
ISSN:0960-1643