Impact of prostate-specific antigen on a baseline prostate cancer risk assessment including genetic risk

A. Karim Kader, Michael A. Liss, Greg Trottier, Seong Tae Kim, Jielin Sun, S. Lilly Zheng, Karen Chadwick, Gina Lockwood, Jianfeng Xu, Neil E. Fleshner

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Results Among 670 patients, 323 (48.2%) were diagnosed with PCa. The PGS-33 was highly associated with biopsy-detectable PCa (odds ratio, 1.66; P = 5.86E-05; AUC, 0.59) compared with PSA (odds ratio, 1.33; P =.01; AUC, 0.55). PSA did not improve risk prediction when added to a baseline model (age, family history, digital rectal examination, and PGS-33) for overall risk (AUC, 0.66 vs 0.66; P =.86) or Gleason score ≥7 PCa (AUC, 0.71 vs 0.73; P =.15). Net reclassification improvement analyses demonstrated no appropriate reclassifications with the addition of PSA to the baseline model for overall PCa but did show some benefit for reclassification of men thought to be at higher baseline risk in the high-grade PCa analysis.

Conclusion In a baseline model of PCa risk including the PGS-33, PSA does not add to risk prediction for overall PCa for men presenting for "for-cause" biopsy. These findings suggest that PSA screening may be minimized in men at low baseline risk.

Methods Peripheral blood deoxyribonucleic acid was obtained from Caucasian men undergoing prostate biopsy at the University of Toronto (September 1, 2008 to January 31, 2010). Thirty-three PCa risk-associated single nucleotide polymorphisms were genotyped to generate the prostate cancer genetic score 33 (PGS-33). Primary outcome is PCa on study prostate biopsy. Logistic regression, area under the receiver-operating characteristic curves (AUC), and net reclassification improvement were used to compare models.

Objective To determine to what extent prostate cancer (PCa) risk prediction is improved by adding prostate-specific antigen (PSA) to a baseline model including genetic risk.

Original languageEnglish (US)
Pages (from-to)165-171
Number of pages7
JournalUrology
Volume85
Issue number1
DOIs
StatePublished - Jan 1 2015

ASJC Scopus subject areas

  • Urology

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    Kader, A. K., Liss, M. A., Trottier, G., Kim, S. T., Sun, J., Zheng, S. L., Chadwick, K., Lockwood, G., Xu, J., & Fleshner, N. E. (2015). Impact of prostate-specific antigen on a baseline prostate cancer risk assessment including genetic risk. Urology, 85(1), 165-171. https://doi.org/10.1016/j.urology.2014.07.081