The Performance of Prostate Specific Antigen for Predicting Prostate Cancer is Maintained After a Prior Negative Prostate Biopsy

Ian M. Thompson, Catherine M. Tangen, Donna P. Ankerst, Chen Chi, M. Scott Lucia, Phyllis Goodman, Howard Parnes, Charles A. Coltman

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Purpose: It has been suggested that prostate specific antigen has no predictive value for prostate cancer after a first negative biopsy has been performed. We compared the performance operating characteristics of prostate specific antigen for prostate cancer between a first and subsequent prostate biopsy in a group of men with complete verification of cancer status. Materials and Methods: From the 18,882 participants in the Prostate Cancer Prevention Trial we examined men in the placebo group who had only a first biopsy or a first and second prostate biopsy with a prostate specific antigen and digital rectal examination within 1 year before each biopsy. The receiver operating characteristic curve was estimated for prostate specific antigen for detection of prostate cancer on the first biopsy compared to the second, and the C-statistics were compared. Results: Of this group 5,608 men had a first biopsy and 687 of those with a negative first biopsy underwent a second biopsy. The C-statistic was 0.650 (95% CI 0.632, 0.668) for the first biopsy and 0.664 (95% CI 0.607, 0.721) for the second biopsy. The C-statistic for the second biopsy was statistically significantly greater than 0.5 (p <0.001) and overlapped with that from the first biopsy. Conclusions: Prostate specific antigen does not lose predictive value for the detection of prostate cancer even after a first biopsy shows no evidence of cancer, and its performance characteristics are only slightly decreased.

Original languageEnglish (US)
Pages (from-to)544-547
Number of pages4
JournalJournal of Urology
Volume180
Issue number2
DOIs
StatePublished - Aug 1 2008

Keywords

  • mass screening
  • prostate-specific antigen
  • prostatic neoplasms
  • sensitivity and specificity

ASJC Scopus subject areas

  • Urology

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