The relationship between prostate-specific antigen and prostate cancer risk: the Prostate Biopsy Collaborative Group. Academic Article uri icon

Overview

abstract

  • PURPOSE: The relationship between prostate-specific antigen (PSA) level and prostate cancer risk remains subject to fundamental disagreements. We hypothesized that the risk of prostate cancer on biopsy for a given PSA level is affected by identifiable characteristics of the cohort under study. EXPERIMENTAL DESIGN: We used data from five European and three U.S. cohorts of men undergoing biopsy for prostate cancer; six were population-based studies and two were clinical cohorts. The association between PSA and prostate cancer was calculated separately for each cohort using locally weighted scatterplot smoothing. RESULTS: The final data set included 25,772 biopsies and 8,503 cancers. There were gross disparities between cohorts with respect to both the prostate cancer risk at a given PSA level and the shape of the risk curve. These disparities were associated with identifiable differences between cohorts: for a given PSA level, a greater number of biopsy cores increased the risk of cancer (odds ratio for >6- versus 6-core biopsy, 1.35; 95% confidence interval, 1.18-1.54; P < 0.0005); recent screening led to a smaller increase in risk per unit change in PSA (P = 0.001 for interaction term) and U.S. cohorts had higher risk than the European cohorts (2.14; 95% confidence interval, 1.99-2.30; P < 0.0005). CONCLUSIONS: Our results suggest that the relationship between PSA and risk of a positive prostate biopsy varies, both in terms of the probability of prostate cancer at a given PSA value and the shape of the risk curve. This poses challenges to the use of PSA-driven algorithms to determine whether biopsy is indicated.

authors

  • Vickers, Andrew J.
  • Cronin, Angel M
  • Roobol, Monique J
  • Hugosson, Jonas
  • Jones, J Stephen
  • Kattan, Michael W
  • Klein, Eric
  • Hamdy, Freddie
  • Neal, David
  • Donovan, Jenny
  • Parekh, Dipen J
  • Ankerst, Donna
  • Bartsch, George
  • Klocker, Helmut
  • Horninger, Wolfgang
  • Benchikh, Amine
  • Salama, Gilles
  • Villers, Arnauld
  • Freedland, Steve J
  • Moreira, Daniel M
  • Schröder, Fritz H
  • Lilja, Hans

publication date

  • August 24, 2010

Research

keywords

  • Prostate
  • Prostate-Specific Antigen
  • Prostatic Neoplasms

Identity

PubMed Central ID

  • PMC2937360

Scopus Document Identifier

  • 77956255132

Digital Object Identifier (DOI)

  • 10.1158/1078-0432.CCR-10-1328

PubMed ID

  • 20736330

Additional Document Info

volume

  • 16

issue

  • 17