Prostate cancer prevention trial risk calculator 2.0 for the prediction of low- vs high-grade prostate cancer

Donna P Ankerst, Josef Hoefler, Sebastian Bock, Phyllis J. Goodman, Andrew Vickers, Javier Hernandez, Lori J. Sokoll, Martin G. Sanda, John T. Wei, Robin J Leach, Ian M. Thompson

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

Objective To modify the Prostate Cancer Prevention Trial risk calculator (PCPTRC) to predict low- vs high-grade (Gleason grade ≥7) prostate cancer and incorporate percent free-prostate-specific antigen (PSA). Methods Data from 6664 Prostate Cancer Prevention Trial placebo arm biopsies (5826 individuals), where prostate-specific antigen and digital rectal examination results were available within 1 year before the biopsy and PSA was ≤10 ng/mL, were used to develop a nominal logistic regression model to predict the risk of no vs low-grade (Gleason grade ;lt&7) vs high-grade cancer (Gleason grade ≥7). Percent free-PSA was incorporated into the model based on likelihood ratio analysis of a San Antonio Biomarkers of Risk cohort. Models were externally validated on 10 Prostate Biopsy Collaborative Group cohorts and 1 Early Detection Research Network reference set. Results Of all the Prostate Cancer Prevention Trial biopsies, 5468 (82.1%) were negative for prostate cancer, 942 (14.1%) detected low-grade, and 254 (3.8%) detected high-grade disease. Significant predictors were (log base 2) PSA (odds ratio for low-grade vs no cancer, 1.29*; high-grade vs no cancer, 2.02*; high-grade vs low-grade cancer, 1.57*), digital rectal examination (0.96, 1.49*, 1.55*, respectively), age (1.02*, 1.05*, 1.03*, respectively), African American race (1.13, 2.83*, 2.51*, respectively), prior biopsy (0.63*, 0.81, 1.27, respectively), and family history (1.31*, 1.25, 0.95, respectively), where* indicates P value ≤.05. The new PCPTRC 2.0 either with or without percent free-PSA (also significant by the likelihood ratio method) validated well externally. Conclusion By differentiating the risk of low- vs high-grade disease on biopsy, PCPTRC 2.0 better enables physician-patient counseling concerning whether to proceed to biopsy.

Original languageEnglish (US)
Pages (from-to)1362-1367
Number of pages6
JournalUrology
Volume83
Issue number6
DOIs
StatePublished - 2014

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Prostate-Specific Antigen
Prostatic Neoplasms
Biopsy
Digital Rectal Examination
Neoplasms
Logistic Models
African Americans
Counseling
Prostate
Biomarkers
Odds Ratio
Placebos
Physicians
Research

ASJC Scopus subject areas

  • Urology

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Ankerst, D. P., Hoefler, J., Bock, S., Goodman, P. J., Vickers, A., Hernandez, J., ... Thompson, I. M. (2014). Prostate cancer prevention trial risk calculator 2.0 for the prediction of low- vs high-grade prostate cancer. Urology, 83(6), 1362-1367. https://doi.org/10.1016/j.urology.2014.02.035

Prostate cancer prevention trial risk calculator 2.0 for the prediction of low- vs high-grade prostate cancer. / Ankerst, Donna P; Hoefler, Josef; Bock, Sebastian; Goodman, Phyllis J.; Vickers, Andrew; Hernandez, Javier; Sokoll, Lori J.; Sanda, Martin G.; Wei, John T.; Leach, Robin J; Thompson, Ian M.

In: Urology, Vol. 83, No. 6, 2014, p. 1362-1367.

Research output: Contribution to journalArticle

Ankerst, DP, Hoefler, J, Bock, S, Goodman, PJ, Vickers, A, Hernandez, J, Sokoll, LJ, Sanda, MG, Wei, JT, Leach, RJ & Thompson, IM 2014, 'Prostate cancer prevention trial risk calculator 2.0 for the prediction of low- vs high-grade prostate cancer', Urology, vol. 83, no. 6, pp. 1362-1367. https://doi.org/10.1016/j.urology.2014.02.035
Ankerst, Donna P ; Hoefler, Josef ; Bock, Sebastian ; Goodman, Phyllis J. ; Vickers, Andrew ; Hernandez, Javier ; Sokoll, Lori J. ; Sanda, Martin G. ; Wei, John T. ; Leach, Robin J ; Thompson, Ian M. / Prostate cancer prevention trial risk calculator 2.0 for the prediction of low- vs high-grade prostate cancer. In: Urology. 2014 ; Vol. 83, No. 6. pp. 1362-1367.
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abstract = "Objective To modify the Prostate Cancer Prevention Trial risk calculator (PCPTRC) to predict low- vs high-grade (Gleason grade ≥7) prostate cancer and incorporate percent free-prostate-specific antigen (PSA). Methods Data from 6664 Prostate Cancer Prevention Trial placebo arm biopsies (5826 individuals), where prostate-specific antigen and digital rectal examination results were available within 1 year before the biopsy and PSA was ≤10 ng/mL, were used to develop a nominal logistic regression model to predict the risk of no vs low-grade (Gleason grade ;lt&7) vs high-grade cancer (Gleason grade ≥7). Percent free-PSA was incorporated into the model based on likelihood ratio analysis of a San Antonio Biomarkers of Risk cohort. Models were externally validated on 10 Prostate Biopsy Collaborative Group cohorts and 1 Early Detection Research Network reference set. Results Of all the Prostate Cancer Prevention Trial biopsies, 5468 (82.1{\%}) were negative for prostate cancer, 942 (14.1{\%}) detected low-grade, and 254 (3.8{\%}) detected high-grade disease. Significant predictors were (log base 2) PSA (odds ratio for low-grade vs no cancer, 1.29*; high-grade vs no cancer, 2.02*; high-grade vs low-grade cancer, 1.57*), digital rectal examination (0.96, 1.49*, 1.55*, respectively), age (1.02*, 1.05*, 1.03*, respectively), African American race (1.13, 2.83*, 2.51*, respectively), prior biopsy (0.63*, 0.81, 1.27, respectively), and family history (1.31*, 1.25, 0.95, respectively), where* indicates P value ≤.05. The new PCPTRC 2.0 either with or without percent free-PSA (also significant by the likelihood ratio method) validated well externally. Conclusion By differentiating the risk of low- vs high-grade disease on biopsy, PCPTRC 2.0 better enables physician-patient counseling concerning whether to proceed to biopsy.",
author = "Ankerst, {Donna P} and Josef Hoefler and Sebastian Bock and Goodman, {Phyllis J.} and Andrew Vickers and Javier Hernandez and Sokoll, {Lori J.} and Sanda, {Martin G.} and Wei, {John T.} and Leach, {Robin J} and Thompson, {Ian M.}",
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T1 - Prostate cancer prevention trial risk calculator 2.0 for the prediction of low- vs high-grade prostate cancer

AU - Ankerst, Donna P

AU - Hoefler, Josef

AU - Bock, Sebastian

AU - Goodman, Phyllis J.

AU - Vickers, Andrew

AU - Hernandez, Javier

AU - Sokoll, Lori J.

AU - Sanda, Martin G.

AU - Wei, John T.

AU - Leach, Robin J

AU - Thompson, Ian M.

PY - 2014

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N2 - Objective To modify the Prostate Cancer Prevention Trial risk calculator (PCPTRC) to predict low- vs high-grade (Gleason grade ≥7) prostate cancer and incorporate percent free-prostate-specific antigen (PSA). Methods Data from 6664 Prostate Cancer Prevention Trial placebo arm biopsies (5826 individuals), where prostate-specific antigen and digital rectal examination results were available within 1 year before the biopsy and PSA was ≤10 ng/mL, were used to develop a nominal logistic regression model to predict the risk of no vs low-grade (Gleason grade ;lt&7) vs high-grade cancer (Gleason grade ≥7). Percent free-PSA was incorporated into the model based on likelihood ratio analysis of a San Antonio Biomarkers of Risk cohort. Models were externally validated on 10 Prostate Biopsy Collaborative Group cohorts and 1 Early Detection Research Network reference set. Results Of all the Prostate Cancer Prevention Trial biopsies, 5468 (82.1%) were negative for prostate cancer, 942 (14.1%) detected low-grade, and 254 (3.8%) detected high-grade disease. Significant predictors were (log base 2) PSA (odds ratio for low-grade vs no cancer, 1.29*; high-grade vs no cancer, 2.02*; high-grade vs low-grade cancer, 1.57*), digital rectal examination (0.96, 1.49*, 1.55*, respectively), age (1.02*, 1.05*, 1.03*, respectively), African American race (1.13, 2.83*, 2.51*, respectively), prior biopsy (0.63*, 0.81, 1.27, respectively), and family history (1.31*, 1.25, 0.95, respectively), where* indicates P value ≤.05. The new PCPTRC 2.0 either with or without percent free-PSA (also significant by the likelihood ratio method) validated well externally. Conclusion By differentiating the risk of low- vs high-grade disease on biopsy, PCPTRC 2.0 better enables physician-patient counseling concerning whether to proceed to biopsy.

AB - Objective To modify the Prostate Cancer Prevention Trial risk calculator (PCPTRC) to predict low- vs high-grade (Gleason grade ≥7) prostate cancer and incorporate percent free-prostate-specific antigen (PSA). Methods Data from 6664 Prostate Cancer Prevention Trial placebo arm biopsies (5826 individuals), where prostate-specific antigen and digital rectal examination results were available within 1 year before the biopsy and PSA was ≤10 ng/mL, were used to develop a nominal logistic regression model to predict the risk of no vs low-grade (Gleason grade ;lt&7) vs high-grade cancer (Gleason grade ≥7). Percent free-PSA was incorporated into the model based on likelihood ratio analysis of a San Antonio Biomarkers of Risk cohort. Models were externally validated on 10 Prostate Biopsy Collaborative Group cohorts and 1 Early Detection Research Network reference set. Results Of all the Prostate Cancer Prevention Trial biopsies, 5468 (82.1%) were negative for prostate cancer, 942 (14.1%) detected low-grade, and 254 (3.8%) detected high-grade disease. Significant predictors were (log base 2) PSA (odds ratio for low-grade vs no cancer, 1.29*; high-grade vs no cancer, 2.02*; high-grade vs low-grade cancer, 1.57*), digital rectal examination (0.96, 1.49*, 1.55*, respectively), age (1.02*, 1.05*, 1.03*, respectively), African American race (1.13, 2.83*, 2.51*, respectively), prior biopsy (0.63*, 0.81, 1.27, respectively), and family history (1.31*, 1.25, 0.95, respectively), where* indicates P value ≤.05. The new PCPTRC 2.0 either with or without percent free-PSA (also significant by the likelihood ratio method) validated well externally. Conclusion By differentiating the risk of low- vs high-grade disease on biopsy, PCPTRC 2.0 better enables physician-patient counseling concerning whether to proceed to biopsy.

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