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Review
. 2014 Oct;15(11):e484-92.
doi: 10.1016/S1470-2045(14)70211-6.

Prevention and Early Detection of Prostate Cancer

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Free PMC article
Review

Prevention and Early Detection of Prostate Cancer

Jack Cuzick et al. Lancet Oncol. .
Free PMC article

Abstract

Prostate cancer is a common malignancy in men and the worldwide burden of this disease is rising. Lifestyle modifications such as smoking cessation, exercise, and weight control offer opportunities to reduce the risk of developing prostate cancer. Early detection of prostate cancer by prostate-specific antigen (PSA) screening is controversial, but changes in the PSA threshold, frequency of screening, and the use of other biomarkers have the potential to minimise the overdiagnosis associated with PSA screening. Several new biomarkers for individuals with raised PSA concentrations or those diagnosed with prostate cancer are likely to identify individuals who can be spared aggressive treatment. Several pharmacological agents such as 5α-reductase inhibitors and aspirin could prevent development of prostate cancer. In this Review, we discuss the present evidence and research questions regarding prevention, early detection of prostate cancer, and management of men either at high risk of prostate cancer or diagnosed with low-grade prostate cancer.

Conflict of interest statement

Conflicts of interest:

JC reports grants from Cancer Research UK, the Prostate Cancer UK, the Association for International Cancer Research, during the conduct of the study; grants, personal fees from Myriad Genetics, personal fees, non-financial support from Bayer, and membership of advisory board of Myriad Genetics and Bayer, outside the submitted work. MAT reports grants from Cancer Research UK, the Prostate Cancer UK, the Association for International Cancer Research, during the conduct of the study. GA reports grants from NCI, during the conduct of the study; personal fees from Augmenix, Bayer, Genomic Health, GlaxoSmithKline, Myriad Genetics, research grants from Johnson & Johnson, Medivation, Wilex, outside the submitted work. PHB serves as a Scientific Advisory Board Member for Susan G. Komen Foundation, outside the submitted work. RAE reports Medical Education support from Janssen, personal fees and expenses from Succinct Communications, outside the submitted work. LH reports support from Swedish County Authorities, during the conduct of the study, in his capacity as the head of a publicly funded regional cancer centre that has the remit to oversee early detection and prevention for cancer in one of six health care regions in Sweden. HL reports grants from National Cancer Institute (R01CA160816; P50-CA92629) to MSKCC, New York, NY, USA, grants from David H. Koch through the Prostate Cancer Foundation to the Sidney Kimmel Center for Prostate and Urological cancers at MSKCC, New York, NY, USA, grants from Swedish Cancer Society (nr 11-0624) to Lund University, Malmö Sweden, grants from Fundacion Federico SA grant to Lund University, Malmö Sweden, grants from the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre Program, University of Oxford, Oxford, UK, during the conduct of the study; In addition, HL holds a patent for free PSA, intact PSA and hK2 assays with royalties paid to Arctic Partners, and a patent application for a statistical method to detect prostate cancer filed by Arctic Partners and licensed to OPKO. MM reports grants and personal fees from GSK, grants and personal fees from MSD, during the conduct of the study; grants and personal fees from GSK, and MSD, outside the submitted work. FLM reports travel support from Cancer Prevention Pharmaceuticals, outside the submitted work; FLM is a co-Founder of Cancer Prevention Pharmaceuticals. CP reports grants and personal fees from Bayer, personal fees from Astellas, BNIT, Janssen, Sanofi-Aventis, Takeda, outside the submitted work. BT reports personal fees from Amgen, grants and personal fees from Astellas, and Ferring, personal fees from Medivation, Bayer, Dendreon, non-financial support from IPSEN, outside the submitted work. The other authors declared no conflicts of interest

Figures

Figure
Figure. Prevention and Early Detection of Prostate Cancer
Potential modifiable and non-modifiable risk factors, pharmacological agents, early detection and triage strategies for of prostate cancer prevention and early detection, many of these are yet to be established.

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