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BJU Int. 2012 Aug;110(3):375-81. doi: 10.1111/j.1464-410X.2011.10925.x. Epub 2012 Feb 7.

An examination of the dynamic changes in prostate-specific antigen occurring in a population-based cohort of men over time.

Author information

1
Division of Urology, Duke University Medical Center, Durham, NC 27710, USA. brant.inman@duke.edu

Abstract

OBJECTIVE:

• To determine whether prostate-specific antigen velocity (PSA-V), PSA doubling time (PSA-DT), or PSA percentage change (PSA-PC) add incremental information to PSA alone for community-based men undergoing prostate cancer (PCa) screening.

PARTICIPANTS AND METHODS:

• A population-based cohort of 11 872 men from Olmsted County, MN undergoing PSA screening for PCa from 1993 to 2005 was analysed for PSA, PSA-DT, PSA-PC and PSA-V and subsequent PCa. • Receiver-operating characteristics curves and logistic regression were used to calculate the area under the curve (AUC) and Aikaike's information criterion. • Reclassification analysis was performed and the net reclassification improvement and integrated discrimination improvement were measured. • The method of Begg and Greenes was used to adjust for verification bias.

RESULTS:

• The single best predictor of future PCa was PSA (AUC = 0.773) with PSA-V (AUC = 0.729) and PSA-DT/PSA-PC (AUC = 0.689) performing worse. • After age adjustment, combining PSA with PSA-V (AUC = 0.773) or PSA-DT/PSA-PC (AUC = 0.773) resulted in no better predictions than PSA alone. • Reclassification analysis showed that adding PSA-V or PSA-DT/PSA-PC to PSA did not result in a meaningful amount of reclassification.

CONCLUSIONS:

• PSA is a better predictor of future PCa than PSA-V, PSA-DT, or PSA-PC. • Adding PSA-V, PSA-DT, or PSA-PC to PSA does not result in clinically relevant improvements in the ability to predict future PCa.

PMID:
22313933
PMCID:
PMC3637967
DOI:
10.1111/j.1464-410X.2011.10925.x
[Indexed for MEDLINE]
Free PMC Article
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