TY - JOUR T1 - Changes in Gleason Scores for Prostate Cancer JF - Journal of Investigative Medicine JO - J Investig Med SP - 625 LP - 628 DO - 10.2310/JIM.0b013e3181d4720c VL - 58 IS - 4 AU - Jorge Ramos AU - Edward Uchio AU - Mihaela Aslan AU - John Concato Y1 - 2010/04/01 UR - http://hw-f5-jim.highwire.org/content/58/4/625.abstract N2 - Background Men diagnosed with prostate cancer receive therapy based on various clinical characteristics, including the Gleason score, a measurement (range, 2-10) describing a tumor's histological appearance. An upward shift has occurred in the distribution of Gleason scores during the past decade; this change was influenced by reports suggesting that lower scores (range, 2-4) should not be assigned to biopsy specimens.Methods We (1) compared Gleason scores from 1994-1995 and 2004-2005 at the same institution, (2) reviewed representative articles examining changes in Gleason scores during the last 2 decades, and (3) assessed the implications of a change in histological measurements.Results Among men diagnosed with prostate cancer at VA Connecticut, Gleason scores 2 to 4 were reported for 11.4% (19/167) of specimens in 1994-1995 but only 0.4% (1/260) of specimens in 2004-2005; this difference persisted after adjusting for age, clinical stage, and prostate-specific antigen (P < 0.001). Similar results were evident in previous publications on this topic. A change in criteria for a clinical measurement may have unintended consequences, including problems of inconsistency across "time" and "place."Conclusions Recent shifts in Gleason scores have led to fewer patients being diagnosed with low-grade prostate cancer; this change can have adverse impacts in clinical care and research. ER -