Adult urologyAge, prostate-specific antigen, and digital rectal examination as determinants of the probability of having prostate cancer☆
Section snippets
Material and methods
The Tyrol Screening Project was conducted in the federal state of Tyrol, Austria between September 1993 and September 1997 using serum PSA and DRE as the initial tests for the early detection of prostate cancer. Approximately 65,000 male residents of Tyrol between 45 and 75 years of age were invited to participate in this screening project through press releases, radio announcements, and television programs. Of these men, 21,078 (32%) agreed to participate in the screening. The inclusion and
Results
The patient age and PSA distributions for the 2054 men are shown in FIGURE 1, FIGURE 2, respectively. We divided age into quartiles of 10 years each, and divided PSA into ranges on the basis of the clinical significance and established cutpoints. Men with cancer were older than men with benign disease and had higher PSA levels. Most men were between 51 and 70 years of age, had benign DRE results, and had PSA levels between 4.0 and 10.0 ng/mL. The prostate biopsies performed on the 2054 men
Comment
The use of PSA for prostate cancer early detection is ubiquitous. The sensitivity of PSA for signaling the presence of cancer is better than DRE, but both of these modalities are limited by poor specificity and thus trigger the performance of many potentially unnecessary biopsies.18, 19 We analyzed the clinical parameters of patient age, PSA level, and DRE result when used together as predictors of biopsy result in a cohort of 2054 men. The resulting finding that increasing age, increasing PSA,
Conclusions
DRE status has a large influence on the likelihood of a positive prostate biopsy within all PSA ranges and age groups. A combination of PSA level, DRE result, and patient age better defines the probability of a positive biopsy than any factor alone. Using this nomogram, the decision to proceed with, or defer, a prostate biopsy can be based on the actual likelihood of having prostate cancer discovered rather than a single PSA-based cutpoint. This may aid in decision-making for physicians and
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Cited by (71)
Quantitative and qualitative impairments in dendritic cell subsets of patients with ovarian or prostate cancer
2020, European Journal of CancerCitation Excerpt :Tumour progression in patients with OvC can often be predicted in the absence of symptoms or radiographic findings by the CA125 value increase, especially when more than twice an augmentation from the nadir level is observed [31]. Furthermore, PSA elevation from the usually low concentrations measured in serum (<4.0 ng/ml) is regarded as an important indicator of PrC progression [32] and its evaluation contributes to the early detection of PrC [33]. We investigated whether the frequency of DC subsets was associated with CA125 or PSA levels.
Predictive factors of prostate cancer diagnosis with PSA 4.0–10.0 ng/ml in a multi-ethnic Asian population, Malaysia
2020, Asian Journal of SurgeryCitation Excerpt :The prostate cancer detection rate of transrectal ultrasound (TRUS)-guided prostate biopsy generally varies according to the prostate specific antigen (PSA) range. Previous studies revealed that the number of prostate cancers detected were 12–29%, 17–37% and 40–69% for total PSA ranged between 4.0 and 10.0 ng/ml, 10.0–20.0 ng/ml and ≥20.0 ng/ml respectively.3–5 It is worth noting that PSA range of 4.0–10.0 ng/ml, also termed as the diagnostic ‘gray zone’, has posed as a challenge in prostate cancer detection due to its high false negative rate of prostate biopsy.
Nomogram for predicting the probability of the positive outcome of prostate biopsies among Ghanaian men
2018, African Journal of UrologyCitation Excerpt :Due to the pains and associated problems, the procedure should be circumvented in men with a low prostate cancer probability [6,7]. To improve the rates of prostate cancer detection and to reduce associated problems, predictive models for prostate cancer using laboratory, clinical and ultrasound parameters have been developed [8–10]. At present, numerous prevailing models had been developed to predict positive prostate biopsy outcome among men undertaking assessment for cancer of the prostate [11].
Benign Prostatic Hyperplasia: Clinical Manifestations and Evaluation
2012, Techniques in Vascular and Interventional RadiologyCitation Excerpt :Although its positive predictive value is not high 26%-34%,2 it is believed that DRE has a higher positive predictive value for cancer among men with LUTS, as these patients are usually older. DRE had a significant influence on the possibility of a PCa, diagnosed by prostate biopsy, in all prostate-specific antigen (PSA) and age ranges.3 A fact that is frequently forgotten in many studies, regarding DRE, is that a proper training is needed to correctly perform a DRE.
Are repeat prostate biopsies safe? A cohort analysis from the SEARCH database
2012, Journal of Urology
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This study was supported by SPORE grant 5P50CA58236-08.