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Prostate-specific antigen-based population screening for prostatecancer： current status in Japan and future perspective in Asia

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Asian Journal of Andrology 2015年第3期17卷 475-480页

作者： yasuhide kitagawa mikio namiki Department of Integrative Cancer Therapy and Urology Kanazawa University Graduate School of Medical Science Kanazawa 920-8640 Japan

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 screeninK system in Asian individuals.

关键词： free prostate-specific antigen pro-prostate-specific antigen prostate cancer prostate cancer gene 3 prostate-specificantigen-based population screening serum prostate-specific antigen distribution

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Understanding prostate-specific antigen dynamics in monitoring metastatic castration-resistant prostate cancer： implications for clinical practice

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Asian Journal of Andrology 2017年第2期19卷 143-148页

作者： Atsushi Mizokami Kouji Izumi Hiroyuki Konaka yasuhide kitagawa Yoshifumi Kadono Kazutaka Narimoto Takahiro Nohara Amit K Bahl mikio namiki Department of Integrative Cancer Therapy and Urology Kanazawa University Graduate School of Medical Science 13-1 Takaramachi Kanazawa 920-8640 Japan Bristol Haematology and Oncology Centre University Hospitals Bristol Bristol BS2 8ED UK

Availability of novel hormonal therapies as well as docetaxel and cabazitaxel treatment for metastatic castration-resistant prostate cancer （CRPC） has changed the outlook for this group of patients with improvements in progression-free survival and overall survival. Physicians often diagnose the progression of prostate cancer using serum prostate-specific antigen （PSA）. However, serum PSA is not always correlated with the clinical status in CRPC. To evaluate the PSA dynamics with greater precision, understanding of the control of PSA and of the mechanisms of development of CRPC is needed. Moreover, it is necessary to use new hormonal therapies with an appropriate timing to optimally improve the prognosis and the QOL of the patients. In the present review, we ascertain the PSA dynamics and the mechanisms of the development of CRPC to assist in optimal utilization of the new treatments for mCRPC.

关键词： castration-resistant prostate cancer new hormonal therapy prostate-specific antigen

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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

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Asian Journal of Andrology 2014年第6期16卷 833-837页

作者： yasuhide kitagawa Kazuaki Machioka Hiroshi Yaegashi Kazufumi Nakashima Mitsuo Ofud Kouji Izumi Satoru Ueno Yoshifumi Kadono Hiroyuki Konaka Atsushi Mizokami mikio namiki Department of Integrative Cancer Therapy and Urology Kanazawa University Graduate School of Medical Science Kanazawa 920-8640 Japan

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 m1-1 in 2000, and gradually decreased to approximately 1.30 ng ml-I in 2006. That of participants excluding prostate cancer patients was 1.46 ng m1-1 in 2000, and there was no remarkable change during the study period. The 95t＂ 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 m1-1, 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.

关键词： age-specific prostate-specific antigen reference range prostate cancer prostate-specific antigen-based population screening serum prostate-specific antigen distribution

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荷尔蒙疗法治疗前列腺癌的疗效及副作用：来自日本的经验和观点

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Asian Journal of Andrology 2012年第3期14卷 451-457,I0007,I0008页

作者： mikio namiki Satoru Ueno yasuhide kitagawa Takashi Fukagai Hideyuki Akaza Department of Integrative Cancer Therapy and Urology Kanazawa University Graduate School of Medical Science Kanazawa 920-8640 Japan Department of Urology Showa University School of Medicine Tokyo 142-8666 Japan Research Center for Advanced Science and Technology University of Tokyo Tokyo 153-8903 Japan

Recently, novel anti-androgens and inhibitors of androgen biosynthesis have been developed through the elucidation of mechanisms of castration resistance of prostate cancer. We believe that these new developments will improve hormonal therapy. On the other hand, there has been an increase in criticism of hormonal therapy, because hormonal therapy is supposed to induce adverse effects such as cardiovascular disease. In this review, we have introduced the Japanese experience of hormonal therapy, because we believe that there may be ethnic differences between Caucasians and Asian people in the efficacy and adverse effects of hormonal therapy. First, we showed that primary hormonal therapy can achieve long-term control of localized prostate cancer in some cases and that quality of life of patients receiving hormonal therapy is rather better than previously thought. Neoadjuvant and adjuvant hormonal therapy in cases undergoing radical prostatectomy or radiotherapy are very useful for high-risk or locally advanced prostate cancer. Further clinical trials are required to confirm the efficacy of neoadjuvant or adjuvant hormonal therapy. We showed that the death from cardiovascular dis- eases in Japanese patients receiving hormonal therapy was not higher than that in the general population. However; efforts should be made to decrease the adverse effects of hormonal therapy, because life-style change may increase the susceptibility to adverse effects by hormonal therapy even in Japan. Managements of endocrine and metabolic dysfunction, such as diabetes mellitus, are essential. New hormonal compounds such as selective androgen receptor modulators capable of specifically targeting prostate cancer are expected to be developed.

关键词： adverse effects androgen deprivation therapy hormonal therapy prostate cancer

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