Normal range prostate-specific antigen versus age-specific prostate-specific antigen in screening prostate adenocarcinoma

El-Galley, Rizk; Petros, John A.; Sanders, William H.; Keane, Thomas E.; Galloway, Niall T.M.; Cooner, William H.; Graham, Sam D.

doi:10.1016/s0090-4295(99)80194-0

Cited by 44 publications

(22 citation statements)

References 16 publications

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“…However, PSA levels depend on other clinical factors, such as age, inflammation, and prostate size [16, 17]. Accordingly, many efforts were made to develop prediction models for PC based on clinical, laboratory, and/or ultrasound parameters in order to improve the rates of prostate cancer detection [18, 19].…”

Section: Discussionmentioning

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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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: Discussionmentioning

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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“…22 This fact led Oesterling et al 24 to develop age reference ranges for white men from Olmsted County, Minnesota. 24 Other groups [25][26][27][28] have reported normal reference ranges similar to theirs, all based on a predominantly white population of men without prostate cancer, and all designed so that the test would have 95% specificity.…”

Section: Introductionmentioning

confidence: 92%

Age-specific reference ranges for prostate-specific antigen (PSA) in Jordanian patients

Battikhi

2003

Prostate Cancer Prostatic Dis

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In this study, the normal distribution of total prostate-specific antigen (TPSA) and free prostate-specific antigen (FPSA) values and the appropriate reference ranges for prostate-specific antigen (PSA) in Jordanian patients were established; the values were then compared to those of other studies. Serum TPSA and FPSA levels in 1852 men with no diagnostic prostate cancer, as well as in patients whose PSA value was obtained as part of the clinical work-up of symptoms relating to nonneoplastic urologic conditions, were estimated during the period 1993-2001: 1561 (84.3%) were above 40 y of age or older. We studied the data as a function of age to determine the usefulness of measuring TPSA, FPSA, and their ratio as screening tests for prostate cancer risk patients. Using the 95th percentile, the recommended age-specific reference ranges of TPSA and FPSA values were as follows: for the age group 30-34 y, 2.3 and 0.51 ng/ml, respectively; for the age group 35-39 y, 2.9 and 0.59 ng/ml, respectively; for the age group 40-44 y, 3.2 and 0.63 ng/ml, respectively; for the age group 45-49 y, 3.75 and 0.71 ng/ml, respectively; for the age group 50-54 y, 3.8 and 0.83 ng/ml, respectively; for the age group 55-59 y 3.75 and 0.96 ng/ ml, respectively; for the age group 460 y old, 4.3 and 1.26 ng/ml, respectively. There was a continuous increase in TPSA and FPSA means and medians throughout the study period with a significant correlation (Po0.001, Po0.05) for TPSA and FPSA levels), respectively, and advancing age group. With regard to the ratios of FPSAto-TPSA for each age group we found no correlation between them. As a result, the appropriate upper limit of normal 95th percentile for all ratios was 0.23 for men for all ages. The establishment of appropriate reference ranges for TPSA and FPSA as well as ratios will allow the practicing urologist to incorporate these new parameters into diagnostic evaluation of men at risk for early, potentially curable prostate cancer.

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“…However, it is still difficult to differentially diagnose prostate cancer from benign prostatic disease because PSA levels depend on age, prostate size, and the inflammatory state of the prostate (5, 6). In addition to total PSA, there are other clinical factors that improve the detection rate of prostate cancer, such as age, digital rectal examination (DRE) findings, transrectal ultrasound (TRUS) findings, PSA density (PSAD), PSA velocity, PSAD of transition zone volume (PSADT), percent of free PSA (% free PSA), and age-specific PSA (7-9).…”

Section: Introductionmentioning

confidence: 99%

Initial Biopsy Outcome Prediction in Korean Patients-Comparison of a Noble Web-based Korean Prostate Cancer Risk Calculator versus Prostate-specific Antigen Testing

et al. 2011

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We developed and validated a novel Korean prostate cancer risk calculator (KPCRC) for predicting the probability of a positive initial prostate biopsy in a Korean population. Data were collected from 602 Koreans who underwent initial prostate biopsies due to an increased level of prostate-specific antigen (PSA), a palpable nodule upon digital rectal examination (DRE), or a hypoechoic lesion upon transrectal ultrasound (TRUS). The clinical and laboratory variables were analyzed by simple and multiple logistic regression analysis. The area under the receiver operating characteristic curve (AUC) was computed to compare its performance to PSA testing alone. Prostate cancer was detected in 172 (28.6%) men. Independent predictors included age, DRE findings, PSA level, and prostate transitional zone volume. We developed the KPCRC using these variables. The AUC for the selected model was 0.91, and that of PSA testing alone was 0.83 (P < 0.001). The AUC for the selected model with an additional dataset was 0.79, and that of PSA testing alone was 0.73 (P = 0.004). The calculator is available on the website: http://pcrc.korea.ac.kr. The KPCRC improved the performance of PSA testing alone in predicting the risk of prostate cancer in a Korean population. This calculator would be a practical tool for physicians and patients.

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Normal range prostate-specific antigen versus age-specific prostate-specific antigen in screening prostate adenocarcinoma

Cited by 44 publications

References 16 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

Age-specific reference ranges for prostate-specific antigen (PSA) in Jordanian patients

Initial Biopsy Outcome Prediction in Korean Patients-Comparison of a Noble Web-based Korean Prostate Cancer Risk Calculator versus Prostate-specific Antigen Testing

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