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July 27, 2005

PSA Kinetics and Risk of Death From Prostate CancerIn Search of the Holy Grail of Surrogate End Points

Author Affiliations

Author Affiliation: Department of Radiation Oncology, Duke University Medical Center, Durham, NC.

JAMA. 2005;294(4):493-494. doi:10.1001/jama.294.4.493

Adenocarcinoma of the prostate is the most commonly diagnosed malignancy in men in the United States. It is estimated that, in 2005, 232 000 new cases will be diagnosed and 30 350 men will die from this disease.1 Even though prostate-specific antigen (PSA) screening has not been conclusively demonstrated to reduce mortality from prostate cancer, this practice has been widely adopted in the United States. As a result, more patients are being diagnosed at a younger age and with disease localized to the prostate.1,2 For these patients, radical prostatectomy (RP) and radiation therapy (RT) remain the mainstays of curative therapy.3 Nevertheless, prostate cancer remains primarily a disease of older men, many of whom have other serious coexisting illnesses from which they may be far more likely to die. Thus, it remains a major challenge for the clinician to identify which patients need aggressive treatment and which do not.

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