A four-kallikrein panel for the prediction of repeat prostate biopsy: Data from the European Randomized Study of Prostate Cancer Screening in Rotterdam, Netherlands Journal Article
| Authors: | Gupta, A.; Roobol, M. J.; Savage, C. J.; Peltola, M.; Pettersson, K.; Scardino, P. T.; Vickers, A. J.; Schroder, F. H.; Lilja, H. |
| Article Title: | A four-kallikrein panel for the prediction of repeat prostate biopsy: Data from the European Randomized Study of Prostate Cancer Screening in Rotterdam, Netherlands |
| Abstract: | Background: Most men with elevated levels of prostate-specific antigen (PSA) do not have prostate cancer, leading to a large number of unnecessary biopsies. A statistical model based on a panel of four kallikreins has been shown to predict the outcome of a first prostate biopsy. In this study, we apply the model to an independent data set of men with previous negative biopsy but persistently elevated PSA. Methods: The study cohort consisted of 925 men with a previous negative prostate biopsy and elevated PSA (≥3 ng ml-1), with 110 prostate cancers detected (12%). A previously published statistical model was applied, with recalibration to reflect the lower positive biopsy rates on rebiopsy. Results: The full-kallikrein panel had higher discriminative accuracy than PSA and DRE alone, with area under the curve (AUC) improving from 0.58 (95% confidence interval (CI): 0.52, 0.64) to 0.68 (95% CI: 0.62, 0.74), P<0.001, and high-grade cancer (Gleason 7) at biopsy with AUC improving from 0.76 (95% CI: 0.64, 0.89) to 0.87 (95% CI: 0.81, 0.94), P<0.003). Application of the panel to 1000 men with persistently elevated PSA after initial negative biopsy, at a 15% risk threshold would reduce the number of biopsies by 712; would miss (or delay) the diagnosis of 53 cancers, of which only 3 would be Gleason 7 and the rest Gleason 6 or less. Conclusions: Our data constitute an external validation of a previously published model. The four-kallikrein panel predicts the result of repeat prostate biopsy in men with elevated PSA while dramatically decreasing unnecessary biopsies. © 2010 Cancer Research UK All rights reserved. |
| Keywords: | adult; controlled study; aged; middle aged; major clinical study; cancer risk; cancer diagnosis; cancer grading; diagnostic accuracy; biomarkers; prostate specific antigen; cohort analysis; cancer screening; biopsy; prostate cancer; netherlands; prostate-specific antigen; prostatic neoplasms; laboratory test; models, statistical; prostate biopsy; kallikrein; predictive value of tests; early detection of cancer; kallikreins |
| Journal Title: | British Journal of Cancer |
| Volume: | 103 |
| Issue: | 5 |
| ISSN: | 0007-0920 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2010-08-24 |
| Start Page: | 708 |
| End Page: | 714 |
| Language: | English |
| DOI: | 10.1038/sj.bjc.6605815 |
| PUBMED: | 20664589 |
| PROVIDER: | scopus |
| PMCID: | PMC2938258 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: BJCAA" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work