Can the prostate risk calculator based on western population be applied to asian population?

Yoon, Dae Wui; Park, Jae Young; Yoon, Sungroh; Park, Man Sik; Moon, Du Geon; Lee, Jeong Gu; Schröder, Fritz H.

doi:10.1002/pros.21475

Cited by 43 publications

(33 citation statements)

References 31 publications

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“…These data were identical to those used in the previous studies, and the inclusion/exclusion criteria and the details about TRUS/TRUS biopsy procedure have been described previously [7, 8]. Briefly, biopsy was performed systemically and its indications were increased level of PSA, a palpable nodule upon DRE, or a hypoechoic lesion upon TRUS [7].…”

Section: Methodsmentioning

confidence: 99%

“…Our team showed in previous studies that the Korean Prostate Cancer Risk Calculator was better than a Western calculator in predicting the probability of PC [7, 8]. Here, we developed the Korean Prostate Cancer Risk Calculator for high-grade prostate cancer (KPCRC-HG) in order to reduce overdiagnosis and overtreatment of PC in our daily practice.…”

Section: Introductionmentioning

confidence: 99%

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Development and External Validation of the Korean Prostate Cancer Risk Calculator for High-Grade Prostate Cancer: Comparison with Two Western Risk Calculators in an Asian Cohort

et al. 2017

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PurposeWe developed the Korean Prostate Cancer Risk Calculator for High-Grade Prostate Cancer (KPCRC-HG) that predicts the probability of prostate cancer (PC) of Gleason score 7 or higher at the initial prostate biopsy in a Korean cohort (http://acl.snu.ac.kr/PCRC/RISC/). In addition, KPCRC-HG was validated and compared with internet-based Western risk calculators in a validation cohort.Materials and MethodsUsing a logistic regression model, KPCRC-HG was developed based on the data from 602 previously unscreened Korean men who underwent initial prostate biopsies. Using 2,313 cases in a validation cohort, KPCRC-HG was compared with the European Randomized Study of Screening for PC Risk Calculator for high-grade cancer (ERSPCRC-HG) and the Prostate Cancer Prevention Trial Risk Calculator 2.0 for high-grade cancer (PCPTRC-HG). The predictive accuracy was assessed using the area under the receiver operating characteristic curve (AUC) and calibration plots.ResultsPC was detected in 172 (28.6%) men, 120 (19.9%) of whom had PC of Gleason score 7 or higher. Independent predictors included prostate-specific antigen levels, digital rectal examination findings, transrectal ultrasound findings, and prostate volume. The AUC of the KPCRC-HG (0.84) was higher than that of the PCPTRC-HG (0.79, p<0.001) but not different from that of the ERSPCRC-HG (0.83) on external validation. Calibration plots also revealed better performance of KPCRC-HG and ERSPCRC-HG than that of PCPTRC-HG on external validation. At a cut-off of 5% for KPCRC-HG, 253 of the 2,313 men (11%) would not have been biopsied, and 14 of the 614 PC cases with Gleason score 7 or higher (2%) would not have been diagnosed.ConclusionsKPCRC-HG is the first web-based high-grade prostate cancer prediction model in Korea. It had higher predictive accuracy than PCPTRC-HG in a Korean population and showed similar performance with ERSPCRC-HG in a Korean population. This prediction model could help avoid unnecessary biopsy and reduce overdiagnosis and overtreatment in clinical settings.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development and External Validation of the Korean Prostate Cancer Risk Calculator for High-Grade Prostate Cancer: Comparison with Two Western Risk Calculators in an Asian Cohort

et al. 2017

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“…The PCa detection rate of Korean men (19.6%) receiving mainly extended biopsy (75.3% patients underwent extended biopsy) [8] and Chinese men (25.3%) receiving mainly extended biopsy (mean number of cores: 10.4-10.7) [9] was 19.6% and 25.3%, respectively. Urologists in China [10] and Korea [11] found that these 2 RCs would overestimate the risk of PCa by approximately 20% at predicted probabilities from 20% to 80%, indicating the necessity of developing risk prediction models in Asian populations. Secondly, the original ERSPC-RC and PCPT-RC did not include information of prostate volume (PV) or free PSA ratio.…”

Section: Introductionmentioning

confidence: 98%

Development and external multicenter validation of Chinese Prostate Cancer Consortium prostate cancer risk calculator for initial prostate biopsy

Chen

Xie

Xue

et al. 2016

Urologic Oncology: Seminars and Original Investigations

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“…2 Therefore, nomogram models used to predict the risk of prostate cancer that were generated from male populations in industrialised countries may not be directly applicable to Chinese men. Yoon et al 8 used a Korean population to validate the performance of the Prostate Risk Calculator 3 (based on data from the Dutch cohort of the ERSPC). They found that use of the Prostate Risk Calculator 3 in a Korean population would miss 7% more cancers than in a Caucasian population.…”

Section: Introductionmentioning

confidence: 99%

“…The existing evidence indicates that evaluation of prostate cancer risk should be tailored for different races. [8][9][10] As a result, the development and use of a nomogram for the population from which the nomogram was derived is particularly pertinent. To our knowledge, no nomogram to evaluate the risk of prostate cancer in a Chinese population has been published to date.…”

Section: Introductionmentioning

confidence: 99%

A nomogram based on age, prostate-specific antigen level, prostate volume and digital rectal examination for predicting risk of prostate cancer

Tang¹,

Chen²,

Uhlman³

et al. 2012

Asian J Androl

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Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort. In the present study, we sought to develop a nomogram for predicting the probability of a positive initial prostate biopsy in a Chinese population. A total of 535 Chinese men who underwent a prostatic biopsy for the detection of prostate cancer in the past decade with complete biopsy data were included. Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy. Age, prostate-specific antigen (PSA), prostate volume (PV), digital rectal examination (DRE) status, % free PSA and transrectal ultrasound (TRUS) findings were included in the analysis. A nomogram model was developed that was based on these independent predictors to calculate the probability of a positive initial prostate biopsy. A receiver-operating characteristic curve was used to assess the accuracy of using the nomogram and PSA levels alone for predicting positive prostate biopsy. The rate for positive initial prostate biopsy was 41.7% (223/535). The independent variables used to predict a positive initial prostate biopsy were age, PSA, PV and DRE status. The areas under the receiver-operating characteristic curve for a positive initial prostate biopsy for PSA alone and the nomogram were 79.7% and 84.8%, respectively. Our results indicate that the risk of a positive initial prostate biopsy can be predicted to a satisfactory level in a Chinese population using our nomogram. The nomogram can be used to identify and counsel patients who should consider a prostate biopsy, ultimately enhancing accuracy in diagnosing prostate cancer.

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Can the prostate risk calculator based on western population be applied to asian population?

Abstract: The KPCRC improves the performance of the PRC 3 and PSA testing in predicting Korean population's risk of PCa. It implies that Asian populations need their own risk calculators for PCa.

Cited by 43 publications

References 31 publications

Development and External Validation of the Korean Prostate Cancer Risk Calculator for High-Grade Prostate Cancer: Comparison with Two Western Risk Calculators in an Asian Cohort

Development and External Validation of the Korean Prostate Cancer Risk Calculator for High-Grade Prostate Cancer: Comparison with Two Western Risk Calculators in an Asian Cohort

Development and external multicenter validation of Chinese Prostate Cancer Consortium prostate cancer risk calculator for initial prostate biopsy

A nomogram based on age, prostate-specific antigen level, prostate volume and digital rectal examination for predicting risk of prostate cancer

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