Needle Biopsies on Autopsy Prostates: Sensitivity of Cancer Detection Based on True Prevalence

Haas, Gabriel P.; Delongchamps, Nicolas Barry; Jones, Richard F.; Chandan, Vishal S.; Serio, Angel M.; Vickers, Andrew J.; Jumbelic, Mary I.; Threatte, Gregory A.; Korets, Rus; Lilja, Hans; Roza, Gustavo de la

doi:10.1093/jnci/djm153

Cited by 191 publications

(138 citation statements)

References 25 publications

(13 reference statements)

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“…Note that because the National Cancer Institute reports a single annual probability of prostate cancer incidence for ages greater than 95 and the National Vital Statistics Reports (Arias 2010) reports a single annual probability of all cause mortality for ages greater than 95, we assume that d t are fixed after the age of 95, i.e., N = 95 in our numerical experiment. Our base case biopsy detection rate is 0.8 (Haas et al 2007).…”

Section: Estimating Parametersmentioning

confidence: 94%

“…In reality, about 7-12% of men undergoing biopsy have had a previous negative biopsy (Nguyen et al 2010, Thompson et al 2006. This is likely because the 10-12 cores obtained in a standard office prostate biopsy miss cancer in some men (Haas et al 2007). Importantly, however, a prior negative prostate biopsy is an indicator of the absence of prostate cancer and therefore decreases the probability that the patient will have cancer detected at re-biopsy (Thompson et al 2006, Ashley et al 2008.…”

Section: Structural Propertiesmentioning

confidence: 99%

“…Patients with higher than normal PSA have a greater risk of prostate cancer; however, higher than normal PSA levels may occur for other reasons including natural variation over time, F o r P e e r R e v i e w prostatic infections and benign enlargement of the prostate gland. If a patient's PSA test result is classified as "suspicious", he may be referred for biopsy, which has a negligible false positive rate but a non-trivial false negative rate (about 20% according to Haas et al 2007). In addition to providing imperfect information, biopsies are painful and carry the possibility of side-effects.…”

Section: Introductionmentioning

confidence: 99%

“…For instance, the physical placement of needles based on imaging information is an important and complex decision that is part of the overall screening process. Haas et al (2007) estimated the diagnostic accuracy of needle biopsy, to be approximately 80%. Sofer et al (2003) studied the optimal number of samples, and placement of the individual needles.…”

Section: Introductionmentioning

confidence: 99%

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Optimization of Prostate Biopsy Referral Decisions

Zhang

Denton

Balasubramanian

et al. 2012

M&SOM

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Prostate cancer is the most common solid tumor in American men and is screened for using prostate-specific antigen (PSA) tests. We report on a non-stationary partially observable Markov decision process (POMDP) for prostate biopsy referral decisions. The core states are the patients' prostate cancer related health states, and PSA test results are the observations. Transition probabilities and rewards are inferred from the Mayo Clinic Radical Prostatectomy Registry (MCRPR) and the medical literature. The objective of our model is to maximize expected quality-adjusted life years (QALYs). We solve the POMDP model to obtain an age and belief (probability of having prostate cancer) dependent optimal biopsy referral policy. We also prove a number of structural properties including the existence of a control-limit type policy for the biopsy referral decision. Our empirical results demonstrate a non-decreasing belief threshold in age, and we provide sufficient conditions under which PSA screening should be discontinued for older patients. Finally, the benefits of screening under the optimal biopsy referral policy are estimated, and sensitivity analysis is used to prioritize the model parameters that would benefit from additional data collection.

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Section: Estimating Parametersmentioning

confidence: 94%

Section: Structural Propertiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Optimization of Prostate Biopsy Referral Decisions

Zhang

Denton

Balasubramanian

et al. 2012

M&SOM

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show abstract

“…The risk of prostate cancer increases with age: 40 per cent of 70-year-old men have detectable cancer in the prostate at autopsy. 6 To prevent one death from prostate cancer, 48 screened men need to be treated. 7 The concentration of PSA at age 60 predicts the risk that a man will die from prostate cancer by the age of 85.…”

mentioning

confidence: 99%

Interpretation of PSA levels after radical therapy for prostate cancer

Goonewardene

Phull²,

Bahl³

et al. 2014

Trends Urol & Men's Health

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Prediction of Erectile Function Following Treatment for Prostate Cancer

Alemozaffar¹,

Regan²,

Cooperberg³

et al. 2011

JAMA

267

188

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Context Sexual function is the health-related quality of life (HRQOL) domain most commonly impaired after prostate cancer treatment; however, validated tools to enable personalized prediction of erectile dysfunction after prostate cancer treatment are lacking. Objective To predict long-term erectile function following prostate cancer treatment based on individual patient and treatment characteristics. Design Pretreatment patient characteristics, sexual HRQOL, and treatment details measured in a longitudinal academic multicenter cohort (Prostate Cancer Outcomes and Satisfaction With Treatment Quality Assessment; enrolled from 2003 through 2006), were used to develop models predicting erectile function 2 years after treatment. A community-based cohort (community-based Cancer of the Prostate Strategic Urologic Research Endeavor [CaPSURE]; enrolled 1995 through 2007) externally validated model performance. Patients in US academic and community-based practices whose HRQOL was measured pretreatment (N = 1201) underwent follow-up after prostatectomy, external radiotherapy, or brachytherapy for prostate cancer. Sexual outcomes among men completing 2 years’ follow-up (n = 1027) were used to develop models predicting erectile function that were externally validated among 1913 patients in a community-based cohort. Main Outcome Measures Patient-reported functional erections suitable for intercourse 2 years following prostate cancer treatment. Results Two years after prostate cancer treatment, 368 (37% [95% CI, 34%–40%]) of all patients and 335 (48% [95% CI, 45%–52%]) of those with functional erections prior to treatment reported functional erections; 531 (53% [95% CI, 50%–56%]) of patients without penile prostheses reported use of medications or other devices for erectile dysfunction. Pretreatment sexual HRQOL score, age, serum prostate-specific antigen level, race/ethnicity, body mass index, and intended treatment details were associated with functional erections 2 years after treatment. Multivariable logistic regression models predicting erectile function estimated 2-year function probabilities from as low as 10% or less to as high as 70% or greater depending on the individual’s pretreatment patient characteristics and treatment details. The models performed well in predicting erections in external validation among CaPSURE cohort patients (areas under the receiver operating characteristic curve, 0.77 [95% CI, 0.74–0.80] for prostatectomy; 0.87 [95% CI, 0.80–0.94] for external radiotherapy; and 0.90 [95% CI, 0.85–0.95] for brachytherapy). Conclusion Stratification by pretreatment patient characteristics and treatment details enables prediction of erectile function 2 years after prostatectomy, external radiotherapy, or brachytherapy for prostate cancer.

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Needle Biopsies on Autopsy Prostates: Sensitivity of Cancer Detection Based on True Prevalence

Cited by 191 publications

References 25 publications

Optimization of Prostate Biopsy Referral Decisions

Optimization of Prostate Biopsy Referral Decisions

Interpretation of PSA levels after radical therapy for prostate cancer

Prediction of Erectile Function Following Treatment for Prostate Cancer

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