The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform
Yasuhide Kitagawa - One of the best experts on this subject based on the ideXlab platform.
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Prostate-specific antigen based Population Screening for prostate cancer: current status in Japan and future perspective in Asia
Asian Journal of Andrology, 2020Co-Authors: Yasuhide Kitagawa, Mikio NamikiAbstract:In Western countries, clinical trials on prostate cancer Screening demonstrated a limited benefit for patient survival. In the Asia-Pacific region, including Japan, the rate of prostate-specific antigen (PSA) testing remains very low compared with Western countries, and the benefits of Population-based Screening remain unclear. This review describes the current status of Population Screening and diagnosis for prostate cancer in Japan and discusses the efficacy of Population Screening for the Asian Population. Since the 1990s, Screening systems have been administered by each municipal government in Japan, and decreases in the prostate cancer mortality rate are expected in some regions where the exposure rate to PSA Screening has increased markedly. A Population-based Screening cohort revealed that the proportion of metastatic disease in cancer detected by Screening gradually decreased according to the increased exposure rate, and a decreasing trend in the proportion of cancer with high serum PSA levels after Population Screening was started. The prognosis of the prostate cancer detected by Population Screening was demonstrated to be more favorable than those diagnosed outside of the Population Screening. Recent results in Screening cohorts demonstrated the efficacy of PSA. These recent evidences regarding Population-based Screening in Japan may contribute to establishing the optimal prostate cancer Screening system in Asian individuals
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Decreasing trend in prostate cancer with high serum prostate-specific antigen levels detected at first prostate-specific antigen-based Population Screening in Japan.
Asian Journal of Andrology, 2014Co-Authors: Yasuhide Kitagawa, Kazuaki Machioka, Hiroshi Yaegashi, Kazufumi Nakashima, Mitsuo Ofude, Kouji Izumi, Satoru Ueno, Yoshifumi Kadono, Hiroyuki Konaka, Atsushi MizokamiAbstract:To clarify the recent trends in prostate-specific antigen (PSA) distribution in men in Japan, we analyzed the PSA distributions of men undergoing PSA-based Population Screening. We summarized the annual individual data of PSA-based Population Screening in Kanazawa, Japan, from 2000 to 2011, and analyzed baseline serum PSA values of the participants at the first Population Screening. Serum PSA distributions were estimated in all participants and those excluding prostate cancer patients according to age. From 2000 to 2011, 19 620 men participated aged 54-69 years old in this Screening program. Mean baseline serum PSA level of all participants at the first Screening was 2.64 ng ml−1 in 2000, and gradually decreased to approximately 1.30 ng ml−1 in 2006. That of participants excluding prostate cancer patients was 1.46 ng ml−1 in 2000, and there was no remarkable change during the study period. The 95 th percentiles in the participants excluding prostate cancer patients detected at the first Population Screening of men aged 54-59, 60-64, and 65-69 years old were 2.90, 3.60, and 4.50 ng ml−1 , respectively. After the commencement of Population Screening, the proportion of prostate cancer patients with high serum PSA levels decreased. However, there were no changes in serum PSA levels in men without prostate cancer. Age-specific PSA reference level of men without prostate cancer in Japan was similar to that in China and Korea.
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Clinical characteristics and prostate-specific antigen kinetics of prostate cancer detected in repeat annual Population Screening in Japan.
International Journal of Urology, 2013Co-Authors: Yasuhide Kitagawa, Atsushi Mizokami, Kiyoshi Sawada, Kazuyoshi Nakashima, Kiyoshi Koshida, Takao Nakashima, Kimiomi Miyazaki, Yasuo Takeda, Mikio NamikiAbstract:Objectives To clarify the present status regarding repeat examination in the annual Population Screening system in Japan, and to analyze the clinical characteristics and prostate-specific antigen kinetics of prostate cancer detected in this setting. Methods We summarized the annual individual data of prostate-specific antigen-based Population Screening in Kanazawa, Japan, and analyzed the prostate cancer detection rates at first and repeat Screening. The clinical characteristics were compared between patients detected at first and repeat Screening. The patients were classified according to favorable or unfavorable clinical characteristics of cancer, and prostate-specific antigen kinetics were compared between the two groups. Results From 2000 to 2011, 19 620 men participated in this Screening program, and a total of 59 019 Screenings were carried out. The total annual numbers of examinees increased, and the annual rates of first examinees gradually decreased. The annual detection rates of cancer at total Screening decreased in the second year. The annual detection rate at first Screening was not different from that in the first year. The rate of patients with favorable cancer features was significantly higher among patients detected at repeat Screening than at first Screening. The rates of patients with high prostate-specific antigen velocity and low prostate-specific antigen doubling time were significantly higher in unfavorable than favorable cancer patients in repeat Screening. Conclusions Repeat Population Screening could contribute to early detection of prostate cancer, and it seems that prostate-specific antigen kinetics might predict the cancer characteristics in repeat Screening.
Mikio Namiki - One of the best experts on this subject based on the ideXlab platform.
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Prostate-specific antigen based Population Screening for prostate cancer: current status in Japan and future perspective in Asia
Asian Journal of Andrology, 2020Co-Authors: Yasuhide Kitagawa, Mikio NamikiAbstract:In Western countries, clinical trials on prostate cancer Screening demonstrated a limited benefit for patient survival. In the Asia-Pacific region, including Japan, the rate of prostate-specific antigen (PSA) testing remains very low compared with Western countries, and the benefits of Population-based Screening remain unclear. This review describes the current status of Population Screening and diagnosis for prostate cancer in Japan and discusses the efficacy of Population Screening for the Asian Population. Since the 1990s, Screening systems have been administered by each municipal government in Japan, and decreases in the prostate cancer mortality rate are expected in some regions where the exposure rate to PSA Screening has increased markedly. A Population-based Screening cohort revealed that the proportion of metastatic disease in cancer detected by Screening gradually decreased according to the increased exposure rate, and a decreasing trend in the proportion of cancer with high serum PSA levels after Population Screening was started. The prognosis of the prostate cancer detected by Population Screening was demonstrated to be more favorable than those diagnosed outside of the Population Screening. Recent results in Screening cohorts demonstrated the efficacy of PSA. These recent evidences regarding Population-based Screening in Japan may contribute to establishing the optimal prostate cancer Screening system in Asian individuals
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Clinical characteristics and prostate-specific antigen kinetics of prostate cancer detected in repeat annual Population Screening in Japan.
International Journal of Urology, 2013Co-Authors: Yasuhide Kitagawa, Atsushi Mizokami, Kiyoshi Sawada, Kazuyoshi Nakashima, Kiyoshi Koshida, Takao Nakashima, Kimiomi Miyazaki, Yasuo Takeda, Mikio NamikiAbstract:Objectives To clarify the present status regarding repeat examination in the annual Population Screening system in Japan, and to analyze the clinical characteristics and prostate-specific antigen kinetics of prostate cancer detected in this setting. Methods We summarized the annual individual data of prostate-specific antigen-based Population Screening in Kanazawa, Japan, and analyzed the prostate cancer detection rates at first and repeat Screening. The clinical characteristics were compared between patients detected at first and repeat Screening. The patients were classified according to favorable or unfavorable clinical characteristics of cancer, and prostate-specific antigen kinetics were compared between the two groups. Results From 2000 to 2011, 19 620 men participated in this Screening program, and a total of 59 019 Screenings were carried out. The total annual numbers of examinees increased, and the annual rates of first examinees gradually decreased. The annual detection rates of cancer at total Screening decreased in the second year. The annual detection rate at first Screening was not different from that in the first year. The rate of patients with favorable cancer features was significantly higher among patients detected at repeat Screening than at first Screening. The rates of patients with high prostate-specific antigen velocity and low prostate-specific antigen doubling time were significantly higher in unfavorable than favorable cancer patients in repeat Screening. Conclusions Repeat Population Screening could contribute to early detection of prostate cancer, and it seems that prostate-specific antigen kinetics might predict the cancer characteristics in repeat Screening.
Atsushi Mizokami - One of the best experts on this subject based on the ideXlab platform.
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Decreasing trend in prostate cancer with high serum prostate-specific antigen levels detected at first prostate-specific antigen-based Population Screening in Japan.
Asian Journal of Andrology, 2014Co-Authors: Yasuhide Kitagawa, Kazuaki Machioka, Hiroshi Yaegashi, Kazufumi Nakashima, Mitsuo Ofude, Kouji Izumi, Satoru Ueno, Yoshifumi Kadono, Hiroyuki Konaka, Atsushi MizokamiAbstract:To clarify the recent trends in prostate-specific antigen (PSA) distribution in men in Japan, we analyzed the PSA distributions of men undergoing PSA-based Population Screening. We summarized the annual individual data of PSA-based Population Screening in Kanazawa, Japan, from 2000 to 2011, and analyzed baseline serum PSA values of the participants at the first Population Screening. Serum PSA distributions were estimated in all participants and those excluding prostate cancer patients according to age. From 2000 to 2011, 19 620 men participated aged 54-69 years old in this Screening program. Mean baseline serum PSA level of all participants at the first Screening was 2.64 ng ml−1 in 2000, and gradually decreased to approximately 1.30 ng ml−1 in 2006. That of participants excluding prostate cancer patients was 1.46 ng ml−1 in 2000, and there was no remarkable change during the study period. The 95 th percentiles in the participants excluding prostate cancer patients detected at the first Population Screening of men aged 54-59, 60-64, and 65-69 years old were 2.90, 3.60, and 4.50 ng ml−1 , respectively. After the commencement of Population Screening, the proportion of prostate cancer patients with high serum PSA levels decreased. However, there were no changes in serum PSA levels in men without prostate cancer. Age-specific PSA reference level of men without prostate cancer in Japan was similar to that in China and Korea.
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Clinical characteristics and prostate-specific antigen kinetics of prostate cancer detected in repeat annual Population Screening in Japan.
International Journal of Urology, 2013Co-Authors: Yasuhide Kitagawa, Atsushi Mizokami, Kiyoshi Sawada, Kazuyoshi Nakashima, Kiyoshi Koshida, Takao Nakashima, Kimiomi Miyazaki, Yasuo Takeda, Mikio NamikiAbstract:Objectives To clarify the present status regarding repeat examination in the annual Population Screening system in Japan, and to analyze the clinical characteristics and prostate-specific antigen kinetics of prostate cancer detected in this setting. Methods We summarized the annual individual data of prostate-specific antigen-based Population Screening in Kanazawa, Japan, and analyzed the prostate cancer detection rates at first and repeat Screening. The clinical characteristics were compared between patients detected at first and repeat Screening. The patients were classified according to favorable or unfavorable clinical characteristics of cancer, and prostate-specific antigen kinetics were compared between the two groups. Results From 2000 to 2011, 19 620 men participated in this Screening program, and a total of 59 019 Screenings were carried out. The total annual numbers of examinees increased, and the annual rates of first examinees gradually decreased. The annual detection rates of cancer at total Screening decreased in the second year. The annual detection rate at first Screening was not different from that in the first year. The rate of patients with favorable cancer features was significantly higher among patients detected at repeat Screening than at first Screening. The rates of patients with high prostate-specific antigen velocity and low prostate-specific antigen doubling time were significantly higher in unfavorable than favorable cancer patients in repeat Screening. Conclusions Repeat Population Screening could contribute to early detection of prostate cancer, and it seems that prostate-specific antigen kinetics might predict the cancer characteristics in repeat Screening.
Lucy Side - One of the best experts on this subject based on the ideXlab platform.
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cost effectiveness of Population Screening for brca mutations in ashkenazi jewish women compared with family history based testing
Journal of the National Cancer Institute, 2015Co-Authors: Ranjit Manchanda, Rosa Legood, Matthew Burnell, Alistair Mcguire, Maria Raikou, K Loggenberg, Jane Wardle, Saskia C Sanderson, S Gessler, Lucy SideAbstract:Background: Population-based testing for BRCA1/2 mutations detects the high proportion of carriers not identified by cancer family history (FH)–based testing. We compared the cost-effectiveness of Population-based BRCA testing with the standard FH-based approach in Ashkenazi Jewish (AJ) women. Methods: A decision-analytic model was developed to compare lifetime costs and effects amongst AJ women in the UK of BRCA founder-mutation testing amongst: 1) all women in the Population age 30 years or older and 2) just those with a strong FH (≥10% mutation risk). The model assumes that BRCA carriers are offered risk-reducing salpingo-oophorectomy and annual MRI/mammography Screening or risk-reducing mastectomy. Model probabilities utilize the Genetic Cancer Prediction through Population Screening trial/published literature to estimate total costs, effects in terms of quality-adjusted life-years (QALYs), cancer incidence, incremental cost-effectiveness ratio (ICER), and Population impact. Costs are reported at 2010 prices. Costs/outcomes were discounted at 3.5%. We used deterministic/probabilistic sensitivity analysis (PSA) to evaluate model uncertainty. Results: Compared with FH-based testing, Population-Screening saved 0.090 more life-years and 0.101 more QALYs resulting in 33 days’ gain in life expectancy. Population Screening was found to be cost saving with a baseline-discounted ICER of -£2079/QALY. Population-based Screening lowered ovarian and breast cancer incidence by 0.34% and 0.62%. Assuming 71% testing uptake, this leads to 276 fewer ovarian and 508 fewer breast cancer cases. Overall, reduction in treatment costs led to a discounted cost savings of £3.7 million. Deterministic sensitivity analysis and 94% of simulations on PSA (threshold £20 000) indicated that Population Screening is cost-effective, compared with current NHS policy. Conclusion: Population-based Screening for BRCA mutations is highly cost-effective compared with an FH-based approach in AJ women age 30 years and older.
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Cost-effectiveness of Population Screening for BRCA Mutations in Ashkenazi Jewish Women Compared With Family History–Based Testing
Journal of the National Cancer Institute, 2014Co-Authors: Ranjit Manchanda, Rosa Legood, Matthew Burnell, Alistair Mcguire, Maria Raikou, K Loggenberg, Jane Wardle, Saskia C Sanderson, S Gessler, Lucy SideAbstract:Background: Population-based testing for BRCA1/2 mutations detects the high proportion of carriers not identified by cancer family history (FH)–based testing. We compared the cost-effectiveness of Population-based BRCA testing with the standard FH-based approach in Ashkenazi Jewish (AJ) women. Methods: A decision-analytic model was developed to compare lifetime costs and effects amongst AJ women in the UK of BRCA founder-mutation testing amongst: 1) all women in the Population age 30 years or older and 2) just those with a strong FH (≥10% mutation risk). The model assumes that BRCA carriers are offered risk-reducing salpingo-oophorectomy and annual MRI/mammography Screening or risk-reducing mastectomy. Model probabilities utilize the Genetic Cancer Prediction through Population Screening trial/published literature to estimate total costs, effects in terms of quality-adjusted life-years (QALYs), cancer incidence, incremental cost-effectiveness ratio (ICER), and Population impact. Costs are reported at 2010 prices. Costs/outcomes were discounted at 3.5%. We used deterministic/probabilistic sensitivity analysis (PSA) to evaluate model uncertainty. Results: Compared with FH-based testing, Population-Screening saved 0.090 more life-years and 0.101 more QALYs resulting in 33 days’ gain in life expectancy. Population Screening was found to be cost saving with a baseline-discounted ICER of -£2079/QALY. Population-based Screening lowered ovarian and breast cancer incidence by 0.34% and 0.62%. Assuming 71% testing uptake, this leads to 276 fewer ovarian and 508 fewer breast cancer cases. Overall, reduction in treatment costs led to a discounted cost savings of £3.7 million. Deterministic sensitivity analysis and 94% of simulations on PSA (threshold £20 000) indicated that Population Screening is cost-effective, compared with current NHS policy. Conclusion: Population-based Screening for BRCA mutations is highly cost-effective compared with an FH-based approach in AJ women age 30 years and older.
W Rosenberg - One of the best experts on this subject based on the ideXlab platform.
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Comparison of genotypic and phenotypic strategies for Population Screening in hemochromatosis: Assessment of anxiety, depression, and perception of health
Genetics in Medicine, 2005Co-Authors: Christine Patch, Paul Roderick, W RosenbergAbstract:PURPOSE: Hemochromatosis is a treatable disorder with a major genetic predisposition. It provides an example in which genotypic and phenotypic strategies for Screening may be compared. We previously showed noninferiority of uptake of a genotypic Population Screening strategy for hemochromatosis compared with a phenotypic strategy. In this article we present the psychologic effects of each strategy. METHODS: A sample of 3000 individuals from primary care were randomly allocated to a phenotypic or genotypic Screening strategy for hemochromatosis, and the 939 individuals who accepted Screening provide the sample for this article. Standardized assessments of anxiety, general health, and depression were made at invitation, testing, result-giving, and 6 months. RESULTS: Screening did not lead to significant changes in the self-rated assessments of anxiety, depression, and general health over time, and there were no significant differences between the two Screening strategies. The unemployed or permanently disabled had lower ratings of health and higher anxiety and depression. CONCLUSION: The two Screening strategies appeared to cause little adverse psychologic disturbance in the short term, and there was no difference between the two strategies This study provides some empiric data to support arguments against "genetic exceptionalism" and suggests that genetic testing when used for Population Screening for a treatable disease has few adverse effects.
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Comparison of genotypic and phenotypic strategies for Population Screening in hemochromatosis: assessment of anxiety, depression, and perception of health.
Genet Med, 2005Co-Authors: W RosenbergAbstract:Hemochromatosis is a treatable disorder with a major genetic predisposition. It provides an example in which genotypic and phenotypic strategies for Screening may be compared. We previously showed noninferiority of uptake of a genotypic Population Screening strategy for hemochromatosis compared with a phenotypic strategy. In this article we present the psychologic effects of each strategy.