Improved XXXX -specific survival and other disease parameters: impact of @entity1486 testing.

@entity1 @entity263 @entity4623 @entity3 @entity204 @entity1486
OBJECTIVES: To determine how the implementation of @entity1486 (PSA) testing has affected disease-specific survival and other characteristics of @entity263 . METHODS: Data were collected on all @entity1 with @entity263 diagnosed between 1988 and 1998 and registered in the Center for @entity4623 Research Database at Walter Reed Army Medical Center. Statistical analyses were used to summarize trends over time in survival, mortality, and clinical stage. RESULTS: Between 1988 and 1998, a total of 2042 @entity1 with @entity263 were registered at Walter Reed Army Medical Center. The 5-year disease-specific survival rate was 86.9% and 93.7% for @entity1 diagnosed in the respective year groups of 1988 to 1991 and 1992 to 1994, with follow-up through December 1, 2000 (P < 0.001). @entity263 was the cause of @entity204 for 37.5% of the @entity1 in 1988 to 1989 versus 15.4% in 1999 to 2000. Marked stage migration has occurred; from 1988 to 1998, the percentage of @entity1 presenting with @entity3 decreased from 14.1% to 3.3% (P < 0.001). CONCLUSIONS: A statistically significant improved 5-year disease-specific survival and a decreased chance of dying from @entity263 has occurred after the widespread implementation of PSA. We suspect that PSA testing has resulted in fewer @entity1 presenting with @entity3 and more @entity1 presenting with localized disease amenable to curative treatment. This portends well for the use of PSA screening to improve outcomes for @entity263 . However, randomized trials are needed to confirm the improvements in survival and mortality.
