Prostate cancer risk prediction in a urology clinic in Mexico

Yuanyuan Liang, Jamie C. Messer, Christopher Louden, Miguel A. Jimenez-Rios, Ian M. Thompson, Hector R. Camarena-Reynoso

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objectives: To evaluate factors affecting the risk of prostate cancer (CaP) and high-grade disease (HGCaP, Gleason score ≥ 7) in a Mexican referral population, with comparison to the Prostate Cancer Prevention Trial Prostate Cancer Risk Calculator (PCPTRC). Methods and materials: From a retrospective study of 826 patients who underwent prostate biopsy between January 2005 and December 2009 at the Instituto Nacional de Cancerología, Mexico, logistic regression was used to assess the effects of age, prostate-specific antigen (PSA), digital rectal exam (DRE), first-degree family history of CaP, and history of a prior prostate biopsy on CaP and HGCaP, separately. Internal discrimination, goodness-of-fit, and clinical utility of the resulting models were assessed with comparison to the PCPTRC. Results: Rates of both CaP (73.2%) and HGCaP (33.3%) were high among referral patients in this Mexican urology clinic. The PCPTRC generally underestimated the risk of CaP but overestimated the risk of HGCaP. Four factors influencing CaP on biopsy were logPSA, DRE, family history and a prior biopsy history (all P < 0.001). The internal AUC of the logistic model was 0.823 compared with 0.785 of the PCPTRC for CaP (P < 0.001). The same 4 factors were significantly associated with HGCaP as well and the AUC was 0.779 compared with 0.766 of the PCPTRC for HGCaP (P = 0.13). Conclusions: Lack of screening programs or regular urologic checkups in Mexico imply that men typically first reach specialized clinics with a high cancer risk. This renders diagnostic tools developed on comparatively healthy populations, such as the PCPTRC, of lesser utility. Continued efforts are needed to develop and externally validate new clinical diagnostic tools specific to high-risk referral populations incorporating new biomarkers and more clinical characteristics.

Original languageEnglish (US)
Pages (from-to)1085-1092
Number of pages8
JournalUrologic Oncology: Seminars and Original Investigations
Issue number7
StatePublished - Oct 2013


  • High-grade prostate cancer
  • Mexico
  • Prostate Cancer Prevention Trial Risk Calculator (PCPTRC)
  • Prostate cancer
  • Prostate specific antigen (PSA)

ASJC Scopus subject areas

  • Oncology
  • Urology


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