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Article: Palliatiivinen urologia.

Taari, Kimmo

Duodecim; laaketieteellinen aikakauskirja

2013 Volume 129, Issue 4, Page(s) 429–431

Abstract: Palliative urology aims to alleviate the symptoms resulting from urinary tract obstruction, hematuria or incontinence and to secure the flow of urine. Palliative surgery is sometimes required to relieve local symptoms caused by the tumor. ...

Title translation	Palliative urology.
Abstract	Palliative urology aims to alleviate the symptoms resulting from urinary tract obstruction, hematuria or incontinence and to secure the flow of urine. Palliative surgery is sometimes required to relieve local symptoms caused by the tumor.
MeSH term(s)	Humans ; Palliative Care/methods ; Urologic Diseases/etiology ; Urologic Diseases/surgery
Language	Finnish
Publishing date	2013
Publishing country	Finland
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	127604-9
ISSN	0012-7183
ISSN	0012-7183
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Article ; Online: Screening history and risk of death from prostate cancer: a nested case-control study within the screening arm of the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC).

Talala, Kirsi / Walter, Stephen / Taari, Kimmo / Tammela, Teuvo L J / Kujala, Paula / Auvinen, Anssi

Cancer causes & control : CCC

2023 Volume 35, Issue 4, Page(s) 695–703

Abstract: Purpose: We assessed the risk of death from prostate cancer (PCa) in relation to men's screening histories, i.e., screening attendance among men who were offered screening.: Methods: Men in the Finnish Randomized Study of Screening for Prostate ... ...

Abstract	Purpose: We assessed the risk of death from prostate cancer (PCa) in relation to men's screening histories, i.e., screening attendance among men who were offered screening. Methods: Men in the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC) screening arm were invited to up to three screening rounds with the serum prostate-specific antigen (PSA) test at 4-year intervals during 1996-2007. Case subjects (n = 330) were men who died from PCa. Each case was matched to five controls (n = 1544) among the men who were free of PCa. Screening history was defined as (1) never/ever attended screening prior to the case diagnosis; (2) attended at the first screening round; and (3) recency of screening, calculated as the time from last screening attendance to the date of case diagnosis. The association between screening history and the risk of death from PCa was estimated by odds ratios (OR) with 95% confidence intervals (CI) using conditional logistic regression. Results: Having ever attended screening versus never attended was associated with a reduced risk of PCa death (OR 0.60, 95% CI 0.45-0.81) and a similar association was found for those attended (versus not attended) the first screening round (OR 0.67, 95% CI 0.51-0.87). The effect by time since last screen for the risk of PCa death was significantly lower 2-7 years since last screen. Conclusion: Among men invited to screening, subjects who attended any PSA screening during the previous 19 years had a 40% reduction in PCa mortality compared to non-screened men.
MeSH term(s)	Humans ; Male ; Case-Control Studies ; Early Detection of Cancer ; Finland/epidemiology ; Mass Screening ; Prostate-Specific Antigen ; Prostatic Neoplasms
Chemical Substances	Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2023-12-08
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1064022-8
ISSN	1573-7225 ; 0957-5243
ISSN (online)	1573-7225
ISSN	0957-5243
DOI	10.1007/s10552-023-01828-2
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Zs.A 3375: Show issues

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Article: Inverse Association between Statin Use and Cancer Mortality Relates to Cholesterol Level.

Peltomaa, Antti I / Talala, Kirsi / Taari, Kimmo / Tammela, Teuvo L J / Auvinen, Anssi / Murtola, Teemu J

Cancers

2022 Volume 14, Issue 12

Abstract: Statins have been associated with a decreased cancer mortality. However, cholesterol level as such may modify the risk of cancer death. To clarify the complex interplay between statins, cholesterol level, and cancer mortality, we conducted a ... ...

Abstract	Statins have been associated with a decreased cancer mortality. However, cholesterol level as such may modify the risk of cancer death. To clarify the complex interplay between statins, cholesterol level, and cancer mortality, we conducted a comprehensive analysis to separate the effects of cholesterol level and statin medication on cancer mortality. Our study population consisted of 16,924 men participating in the Finnish Randomized Study of Screening for Prostate Cancer with at least one cholesterol measurement during follow-up (1996-2017). Cox proportional regression was used to estimate hazard ratios. In total, 1699 cancer deaths were observed during the median follow-up of 19 years. When statins' association with the risk of cancer death was estimated without adjustment for cholesterol level, statin use was associated with a lowered cancer mortality (HR 0.87; 95% CI 0.79-0.97) compared to non-users. However, with further adjustment for total cholesterol level, statin use was no longer associated with a lower cancer mortality (HR 1.08; 95% CI 0.97-1.20). Upon stratified analysis, statin use was associated with a decreased cancer mortality only if the total cholesterol level decreased after the initiation of statin use (HR 0.66; 95% CI 0.58-0.76). The inverse association between statin use and cancer mortality is limited to men with a reduction in total cholesterol level after the commencement of statins, i.e., statin use is associated with a lowered cancer mortality only if the total cholesterol level decreases. This suggests that the effect of statin use on cancer mortality relates to the decreased total cholesterol level.
Language	English
Publishing date	2022-06-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers14122920
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Article ; Online: Antidiabetic drugs, glycemic control and risk of benign prostatic hyperplasia.

Nygård, Lotta H / Talala, Kirsi / Taari, Kimmo / Tammela, Teuvo L J / Auvinen, Anssi / Murtola, Teemu J

The Prostate

2022 Volume 83, Issue 3, Page(s) 246–258

Abstract: Background: Diabetes has been associated with an increased risk of benign prostatic hyperplasia (BPH). However, the role of antidiabetic drugs as a BPH risk factor is unclear. The objective of our study was to examine the risk of BPH by antidiabetic ... ...

Abstract	Background: Diabetes has been associated with an increased risk of benign prostatic hyperplasia (BPH). However, the role of antidiabetic drugs as a BPH risk factor is unclear. The objective of our study was to examine the risk of BPH by antidiabetic drug use and glycemic control in a large population-based cohort of Finnish men. Methods: A total of 74,754 men in the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC) free of BPH at baseline in 1996-1999 were linked to the national medication reimbursement database for information on physician-prescribed antidiabetic drug purchases. Information on recorded BPH procedures and diagnoses was obtained from the National Care Register for Health Care, and for a subgroup of 17,739 men, information on blood glucose levels (BGLs) from the Fimlab Laboratories database. Cox regression with antidiabetic drug use and BGL as time-dependent variables was used to analyze the risks for starting BPH medication, recorded BPH diagnosis, and undergoing BPH surgery. The analysis was adjusted for age, use of statins, antihypertensive medication, and nonsteroidal anti-inflammatory drugs. Results: Of the subjects, 14,012 men (18.7%) used antidiabetic medication. Of the subgroup with fasting blood glucose data available, 7487 (42.2%) had diabetic level. The risks for BPH diagnosis (HR: 1.08, 95% CI: 1.03-1.13) and surgery (HR: 1.16, 95% CI: 1.09-1.24) were slightly elevated among antidiabetic drug users compared to nonusers. The association was strongest for insulin use. Similarly, risk of BPH surgery was increased in men with diabetic blood glucose compared to normoglycemic men. The risk association was attenuated by use of antidiabetic drugs. Conclusions: Diabetic BGL and antidiabetic medication use, especially insulin, are associated with an elevated risk of BPH surgery compared to nondiabetic men. These findings support the roles of insulin use and untreated hyperglycemia as possible BPH risk factors.
MeSH term(s)	Male ; Humans ; Hypoglycemic Agents/adverse effects ; Prostatic Hyperplasia/drug therapy ; Prostatic Hyperplasia/epidemiology ; Prostatic Hyperplasia/surgery ; Blood Glucose ; Glycemic Control ; Diabetes Mellitus ; Prostatic Neoplasms ; Risk Factors ; Insulin/adverse effects
Chemical Substances	Hypoglycemic Agents ; Blood Glucose ; Insulin
Language	English
Publishing date	2022-11-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	604707-5
ISSN	1097-0045 ; 0270-4137
ISSN (online)	1097-0045
ISSN	0270-4137
DOI	10.1002/pros.24456
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Zs.A 1608: Show issues

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Article ; Online: Testosterone replacement therapy is not associated with increased prostate cancer incidence, prostate cancer-specific, or cardiovascular disease-specific mortality in Finnish men.

Siltari, Aino / Murtola, Teemu J / Kausz, Josefina / Talala, Kirsi / Taari, Kimmo / Tammela, Teuvo Lj / Auvinen, Anssi

Acta oncologica (Stockholm, Sweden)

2023 Volume 62, Issue 12, Page(s) 1898–1904

Abstract: Background: Concerns have been expressed over the safety of testosterone replacement therapy (TRT) in men with late-onset hypogonadism (LOH). Previous studies have shown controversial results regarding the association of TRT with the risk of ... ...

Abstract	Background: Concerns have been expressed over the safety of testosterone replacement therapy (TRT) in men with late-onset hypogonadism (LOH). Previous studies have shown controversial results regarding the association of TRT with the risk of cardiovascular events or prostate cancer (PCa) incidence, aggressiveness, and mortality. This study explores the overall risk of PCa and risk by tumor grade and stage, as well as mortality from PCa and cardiovascular disease (CVD), among men treated with TRT compared to men without LOH and TRT use. Materials and methods: The study included 78,615 men of age 55-67 years at baseline from the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC). Follow-up started at randomization and ended at death, emigration, or a common closing date January 1st, 2017. Cox proportional hazards regression model with time-dependent variables and adjustment for age, trial arm, use of other medications, and Charlson comorbidity index was used. Comprehensive information on TRT purchases during 1995-2015 was obtained from the Finnish National Prescription Database. PCa cases were identified from the Finnish Cancer Registry and causes of death obtained from Statistics Finland. Results: Over the course of 18 years of follow-up, 2919 men were on TRT, and 285 PCa cases were diagnosed among them. TRT users did not exhibit a higher incidence or mortality rate of PCa compared to non-users. On the contrary, men using TRT had lower PCa mortality than non-users (HR = 0.52; 95% CI 0.3-0.91). Additionally, TRT users had slightly lower CVD and all-cause mortality compared to non-users (HR = 0.87; 95% CI 0.75-1.01 and HR = 0.93; 95% CI 0.87-1.0, respectively). No time- or dose-dependency of TRT use was evident in any of the analyses. Conclusion: Men using TRT were not associated to increased risk for PCa and did not experience increased PCa- or CVD-specific mortality compared to non-users. Further studies considering blood testosterone levels are warranted.
MeSH term(s)	Aged ; Humans ; Male ; Middle Aged ; Cardiovascular Diseases/epidemiology ; Finland/epidemiology ; Hypogonadism/drug therapy ; Hypogonadism/epidemiology ; Hypogonadism/chemically induced ; Incidence ; Prostatic Neoplasms ; Testosterone/adverse effects
Chemical Substances	Testosterone (3XMK78S47O)
Language	English
Publishing date	2023-11-25
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	896449-x
ISSN	1651-226X ; 0349-652X ; 0284-186X ; 1100-1704
ISSN (online)	1651-226X
ISSN	0349-652X ; 0284-186X ; 1100-1704
DOI	10.1080/0284186X.2023.2278189
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Zs.A 6348: Show issues

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Article ; Online: Expected impact of MRI-targeted biopsy interreader variability among uropathologists on ProScreen prostate cancer screening trial: a pre-trial validation study.

Hietikko, Ronja / Mirtti, Tuomas / Kilpeläinen, Tuomas P / Tolonen, Teemu / Räisänen-Sokolowski, Anne / Nordling, Stig / Hannus, Jill / Laurila, Marita / Taari, Kimmo / Tammela, Teuvo L J / Autio, Reija / Natunen, Kari / Auvinen, Anssi / Rannikko, Antti

World journal of urology

2024 Volume 42, Issue 1, Page(s) 217

Abstract: Purpose: Prostate cancer (PCa) histology, particularly the Gleason score, is an independent prognostic predictor in PCa. Little is known about the inter-reader variability in grading of targeted prostate biopsy based on magnetic resonance imaging (MRI). ...

Abstract	Purpose: Prostate cancer (PCa) histology, particularly the Gleason score, is an independent prognostic predictor in PCa. Little is known about the inter-reader variability in grading of targeted prostate biopsy based on magnetic resonance imaging (MRI). The aim of this study was to assess inter-reader variability in Gleason grading of MRI-targeted biopsy among uropathologists and its potential impact on a population-based randomized PCa screening trial (ProScreen). Methods: From June 2014 to May 2018, 100 men with clinically suspected PCa were retrospectively selected. All men underwent prostate MRI and 86 underwent targeted prostate of the prostate. Six pathologists individually reviewed the pathology slides of the prostate biopsies. The five-tier ISUP (The International Society of Urological Pathology) grade grouping (GG) system was used. Fleiss' weighted kappa (κ) and Model-based kappa for associations were computed to estimate the combined agreement between individual pathologists. Results: GG reporting of targeted prostate was highly consistent among the trial pathologists. Inter-reader agreement for cancer (GG1-5) vs. benign was excellent (Model-based kappa 0.90, Fleiss' kappa κ = 0.90) and for clinically significant prostate cancer (csPCa) (GG2-5 vs. GG0 vs. GG1), it was good (Model-based kappa 0.70, Fleiss' kappa κ 0.67). Conclusions: Inter-reader agreement in grading of MRI-targeted biopsy was good to excellent, while it was fair to moderate for MRI in the same cohort, as previously shown. Importantly, there was wide consensus by pathologists in assigning the contemporary GG on MRI-targeted biopsy suggesting high reproducibility of pathology reporting in the ProScreen trial.
MeSH term(s)	Male ; Humans ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/pathology ; Early Detection of Cancer ; Reproducibility of Results ; Retrospective Studies ; Prostate-Specific Antigen ; Biopsy ; Magnetic Resonance Imaging/methods ; Neoplasm Grading ; Image-Guided Biopsy
Chemical Substances	Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2024-04-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	380333-8
ISSN	1433-8726 ; 0724-4983
ISSN (online)	1433-8726
ISSN	0724-4983
DOI	10.1007/s00345-024-04898-2
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Zs.A 1832: Show issues

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Article ; Online: Which men benefit from prostate cancer screening? Prostate cancer mortality by subgroup in the European Randomised Study of Screening for Prostate Cancer.

Pasanen, Niko / Talala, Kirsi / Remmers, Sebastiaan / Tammela, Teuvo L J / Hugosson, Jonas / Roobol, Monique J / Taari, Kimmo / Arnsrud Godtman, Rebecka / Bangma, Chris / Auvinen, Anssi

BJU international

2024

Abstract: Objective: To evaluate whether a subgroup of men can be identified that would benefit more from screening than others.: Materials and methods: This retrospective cohort study was based on three European Randomised Study of Screening for Prostate ... ...

Abstract	Objective: To evaluate whether a subgroup of men can be identified that would benefit more from screening than others. Materials and methods: This retrospective cohort study was based on three European Randomised Study of Screening for Prostate Cancer (ERSPC) centres, Finland, the Netherlands and Sweden. We identified 126 827 men aged 55-69 years in the study who were followed for maximum of 16 years after randomisation. The primary outcome was prostate cancer (PCa) mortality. We analysed three age groups 55-59, 60-64 and 65-69 years and PCa cases within four European Association of Urology (EAU) risk groups: low, intermediate, high risk, and advanced disease. Results: The hazard ratio (HR) for PCa mortality in the screening arm relative to the control arm for men aged 55-59 years was 0.96 (95% confidence interval [CI] 0.75-1.24) in Finland, 0.70 (95% CI 0.44-1.12) in the Netherlands and 0.42 (95% CI 0.24-0.73) in Sweden. The HR for men aged 60-64 years was 1.03 (95% CI 0.77-1.37) in Finland, 0.76 (95% CI 0.50-1.16) in the Netherlands and 0.97 (95% CI 0.64-1.48) in Sweden. The HR for men aged 65-69 years was 0.80 (95% CI 0.62-1.03) in Finland and 0.57 (95% CI 0.38-0.83) in the Netherlands, and this age group was absent in Sweden. In the EAU risk group analysis, PCa mortality rates were materially lower for men with advanced disease at diagnosis in all three countries: 0.67 (95% CI 0.56-0.82) in Finland, 0.28 (95% CI 0.18-0.44) in the Netherlands, and 0.48 (95% CI 0.30-0.78) in Sweden. Conclusion: We were unable to unequivocally identify the optimal age group for screening, as mortality reduction differed among centres and age groups. Instead, the screening effect appears to depend on screening duration, and the number and frequency of screening rounds. PCa mortality reduction by screening is largely attributable to stage shift.
Language	English
Publishing date	2024-05-09
Publishing country	England
Document type	Journal Article
ZDB-ID	1462191-5
ISSN	1464-410X ; 1464-4096 ; 1358-8672
ISSN (online)	1464-410X
ISSN	1464-4096 ; 1358-8672
DOI	10.1111/bju.16394
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Ui VI Zs.107: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Health-Related Quality of Life and Survival in Prostate Cancer Patients in a Real-World Setting.

Bergius, Susanne / Roine, Risto P / Taari, Kimmo / Sintonen, Harri

Urologia internationalis

2020 Volume 104, Issue 11-12, Page(s) 939–947

Abstract: Objective: To analyze the health-related quality of life (HRQoL) and survival of real-world prostate cancer (PC) patients and to calculate quality-adjusted life-years (QALYs) experienced under different treatment strategies.: Materials and methods: ... ...

Abstract	Objective: To analyze the health-related quality of life (HRQoL) and survival of real-world prostate cancer (PC) patients and to calculate quality-adjusted life-years (QALYs) experienced under different treatment strategies. Materials and methods: PC patients undergoing active surveillance (n = 226), radiation treatment (n = 280), surgery (n = 299), or hormonal treatment (n = 62) responded to the generic 15-dimensional (15D) HRQoL questionnaire at the time of the diagnosis and were followed up 3, 6, 12, and 24 months later. QALYs experienced during the follow-up were calculated for each treatment group, and variables associated with survival were analyzed using Cox proportional hazards models. Results: HRQoL was stable during the first 2 years after diagnosis in all other treatment groups, except in patients treated with hormonal therapy. The overall survival within 6.5-year follow-up time was 84.4%. The number of QALYs experienced during the 2-year follow-up was similar in patients in active surveillance (1.790), surgery (1.784), and radiation groups (1.767), but significantly lower in the hormonal therapy group (1.665). Conclusions: Patients receiving hormonal treatment had significantly impaired HRQoL and survival compared with other treatments. Although the number of QALYs experienced was similar in the 3 other treatment lines, there were marked differences between treatment lines on some 15D dimensions.
MeSH term(s)	Aged ; Humans ; Male ; Prostatic Neoplasms/mortality ; Prostatic Neoplasms/therapy ; Quality of Life ; Retrospective Studies ; Survival Rate
Language	English
Publishing date	2020-09-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	204045-1
ISSN	1423-0399 ; 0042-1138
ISSN (online)	1423-0399
ISSN	0042-1138
DOI	10.1159/000510319
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Article ; Online: Digital rectal examination in prostate cancer screening at PSA level 3.0-3.9 ng/ml: long-term results from a randomized trial.

Soronen, Veera / Talala, Kirsi / Raitanen, Jani / Taari, Kimmo / Tammela, Teuvo / Auvinen, Anssi

Scandinavian journal of urology

2021 Volume 55, Issue 5, Page(s) 348–353

Abstract: Objective: To evaluate digital rectal examination (DRE) as a predictor of prostate cancer (PC) at serum PSA level 3.0-3.9 ng/ml. We compared the PC incidence rates of men with different screening test results in this PSA range and analyzed DRE in ... ...

Abstract	Objective: To evaluate digital rectal examination (DRE) as a predictor of prostate cancer (PC) at serum PSA level 3.0-3.9 ng/ml. We compared the PC incidence rates of men with different screening test results in this PSA range and analyzed DRE in comparison with free/total PSA ratio as an additional screening test. Materials and methods: Using data from the FinRSPC trial, PC incidence rate ratios (IRR) for groups defined by the secondary screening test results (DRE vs. free/total PSA) were calculated for 17-year follow-up, using adjustment for age, family history of PC and place of residence. Screening test performance was evaluated by calculating sensitivity, specificity, positive and negative predictive value, and likelihood ratio. Results: The IRR for men with a positive DRE compared to those with a negative result was 1.40 (95% confidence interval (CI) 1.00-1.96), while the IRR for men with a positive free/total PSA result compared to those with a negative one was 1.62 (95% CI 1.08-2.43). The estimated sensitivity was 0.15 (95% CI 0.11-0.20, 40/270) for DRE and 0.32 (95% CI 0.23-0.41, 36/113) for free/total PSA, and the specificity 0.91 (95% CI 0.88-0.93, 419/461) for DRE and 0.85 (95% CI 0.78-0.90, 134/158) for free/total PSA. Conclusions: Our results do not support utility of DRE as a screening test for PC at serum PSA level 3.0-3.9 ng/ml, while the results regarding free/total PSA determination were more encouraging and reconfirm the decision to switch from DRE to free/total PSA.
MeSH term(s)	Digital Rectal Examination ; Early Detection of Cancer ; Humans ; Male ; Mass Screening ; Predictive Value of Tests ; Prostate-Specific Antigen ; Prostatic Neoplasms/diagnosis
Chemical Substances	Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2021-08-19
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2701936-6
ISSN	2168-1813 ; 2168-1805
ISSN (online)	2168-1813
ISSN	2168-1805
DOI	10.1080/21681805.2021.1966095
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Article ; Online: In memory of Alexander Schultz 1947-2020.

Ljungberg, Börje / Malmström, Per-Uno / Taari, Kimmo / Beisland, Christian / Salling, Lisbeth

Scandinavian journal of urology

2021 Volume 54, Issue 5, Page(s) 363

Language	English
Publishing date	2021-06-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2701936-6
ISSN	2168-1813 ; 2168-1805
ISSN (online)	2168-1813
ISSN	2168-1805
DOI	10.1080/21681805.2020.1831796
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