American cancer society national prostate cancer detection project. Goals and current status

The American Cancer Society National Prostate Cancer Detection Project (ACS-NPCOP) is a collaborative study of the feasibility and cost-benefit balance of early prostate cancer detection. The ACS-NPCDP uses a comparative, cohort research design with participant eligibility restricted to men 55 to 70 years old who were not already being evaluated for the disease. Two thousand nine hundred ninety-nine men are being followed for five annual examinations using digital rectal examination, transrectal ultrasound, and prostate-specific antigen. All prostate cancer findings are confirmed by pathologic review, this writing, 9606 annual examination visits have be completed and 194 cancers have been detected. The detection rate for the first-year examination was 2.8%. In the second and third years, the rate decreased to 1.9% and 1.0%, respectively. The characteristics of cancers detected in the ACS-NPCDP indicate that the combined application of digital rectal examination, transrectal ultrasound, and prostate-specific antigen yields detection clinically significant, potentially curable cancers. Data from the ACS-NPCDP have been used to evaluate the health economics of prostate cancer detection and optimal detection strategies. The available data do not show mortality reduction, and further study of the ACS-NPCDP cohort is required to assess long-term outcomes associated with exposure to prostate cancer early detection Cancer 1995; 75:1790–4.