Re-Examining PSA Density: Defining the Optimal PSA Range and Patients for Using PSA Density to Predict Prostate Cancer Using Extended Template Biopsy

Abstract Objectives To compare the predictive accuracy of PSA density versus PSA across different PSA ranges and by prior biopsy status in a prospective cohort undergoing prostate biopsy. Methods Men from a prospective trial underwent an extended template biopsy to evaluate for prostate cancer at 26...

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Published in:Urology (Ridgewood, N.J.) N.J.), 2017
Main Authors: Jue, Joshua Stephen, BS, Barboza, Marcelo Panizzutti, MD, Prakash, Nachiketh Soodana, MD, MS, Venkatramani, Vivek, MD, Sinha, Varsha R., MD, Pavan, Nicola, Nahar, Bruno, MD, Kanabur, Pratik, MD, Ahdoot, Michael, MD, Dong, Yan, PhD, MS, MPA, Satyanarayana, Ramgopal, MD, Parekh, Dipen J., MD, Punnen, Sanoj, MD, MS
Format: Article
Language:English
Subjects:
Urology
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Summary:Abstract Objectives To compare the predictive accuracy of PSA density versus PSA across different PSA ranges and by prior biopsy status in a prospective cohort undergoing prostate biopsy. Methods Men from a prospective trial underwent an extended template biopsy to evaluate for prostate cancer at 26 sites throughout the US. The area under the receiver operating curve assessed the predictive accuracy of PSA density versus PSA across three PSA ranges (10 ng/mL). We also investigated the effect of varying the PSA density cut-offs on the detection of cancer and assessed the performance of PSA density versus PSA in men with or without a prior negative biopsy. Results Among 1,290 patients, 585 (45%) and 284 (22%) men had prostate cancer and significant prostate cancer, respectively. PSA density performed better than PSA in detecting any prostate cancer within a PSA between 4-10 ng/ml (AUC: 0.70 vs. 0.53, P10 mg/ml (AUC: 0.84 vs. 0.65, P
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2017.04.015