Use of early PSA velocity to predict eventual abnormal PSA values in men at risk for prostate cancer

Riffenburgh, Robert H.; Amling, Christopher L.

doi:10.1038/sj.pcan.4500614

Cited by 16 publications

(10 citation statements)

References 17 publications

(12 reference statements)

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“…Carter et al [6], based on the study of increase in PSA in men who later diagnosed with CaP, suggested that an annual increase in PSA of greater than 0.75 ng/ml per year is indicative of cancer. Contradictory data have been reported regarding the clinical usefulness of PSA velocity in men with PSA levels less than 4.0 ng/ml [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Assessment of intra‐individual variation in prostate‐specific antigen levels in a biennial randomized prostate cancer screening program in Sweden

et al. 2005

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Section: Introductionmentioning

confidence: 99%

Assessment of intra‐individual variation in prostate‐specific antigen levels in a biennial randomized prostate cancer screening program in Sweden

et al. 2005

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“…Several studies have evaluated different methods for calculating PSAV [9–13]; no one method has been accepted as standard. We found that a method which assumes an exponential increase in PSA (the derivative of the linear regression of logPSA on time) applied at the point of PSA transition from linear to exponential, was associated with the highest hazard ratio per unit increase of velocity (and the best model fit), in predicting death from prostate cancer.…”

Section: Discussionmentioning

confidence: 99%

“…The disparity between studies evaluating PSAV could be explained by the manner in which a PSA history is evaluated. For example, different methods of calculation and the use of different time points in a PSA history at which the PSAV is determined could influence the findings [9–13]. Also, the choice of statistical methods for evaluating two highly correlated variables (PSA and PSAV) could influence results [14].…”

Section: Introductionmentioning

confidence: 99%

Interpretation of the prostate‐specific antigen history in assessing life‐threatening prostate cancer

et al. 2010

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Study Type – Diagnosis (validating cohort) Level of Evidence 1b OBJECTIVE To present an effective approach to the early detection of lethal prostate cancer using longitudinal data on prostate‐specific antigen (PSA) and its rate of change, i.e. PSA velocity (PSAV). This longitudinal approach might also be extendible to other biomarkers. SUBJECTS AND METHODS PSAV was calculated using five techniques for 634 subjects with at least three PSA measurements in a longitudinal ageing study, censoring PSA levels of >10 ng/mL. The efficacy for predicting death from prostate cancer was assessed with concordance indices and by using net reclassification improvement (NRI), which indicated the net increase in sensitivity and specificity when adding a biomarker to a base Cox proportional hazards model. The PSAV techniques were compared for the 5–10 years before the clinical diagnosis of prostate cancer. The most effective technique was then applied at the transition point when each man’s PSA history curve transformed from linear to exponentially increasing, and its predictive value was compared to that of concurrent PSA level. RESULTS A PSA transition point was found in 522 (82%) of the 634 men, including all 11 who died from prostate cancer. At the transition point, the mean PSA level was 1.4 ng/mL, and PSAV but not PSA level was significantly higher among men who died from prostate cancer than among men who did not (P= 0.021 vs P= 0.112; Wilcoxon two‐sample test). At the transition point, adding PSAV to a base model consisting of age and date of diagnosis improved the concordance index by 0.05, and significantly improved the overall sensitivity and specificity (NRI, P= 0.028), while adding PSA level to the same base model resulted in little improvement (concordance index increase <0.01 and NRI P= 0.275). CONCLUSION When the shape of a man’s PSA history curve changes from linear to exponential, PSAV might help in the early identification of life‐threatening prostate cancer at a time when PSA values are still low in most men.

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“…However, clinicians often encounter situations where a suboptimal number of measurements are available. Riffenberg and Amling [10] have described 'early PSAV' (defined as the change from the first to second PSA reading standardized as PSA change per year), which can be used in such situations. In this large single-centre retrospective study, there was a highly significant difference in early PSAV between those patients whose PSA level subsequently increased to > 4 ng/mL and who had a positive biopsy result and those who had neither an increase in PSA level or positive biopsy.…”

Section: Psav and Screeningmentioning

confidence: 99%

Current role of prostate‐specific antigen kinetics in managing patients with prostate cancer

Teahan

Klotz

2006

BJU International

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Use of early PSA velocity to predict eventual abnormal PSA values in men at risk for prostate cancer

Cited by 16 publications

References 17 publications

Assessment of intra‐individual variation in prostate‐specific antigen levels in a biennial randomized prostate cancer screening program in Sweden

Assessment of intra‐individual variation in prostate‐specific antigen levels in a biennial randomized prostate cancer screening program in Sweden

Interpretation of the prostate‐specific antigen history in assessing life‐threatening prostate cancer

Current role of prostate‐specific antigen kinetics in managing patients with prostate cancer

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