April 18, 2006JNCI Journal of the National Cancer Institute
Assessing Prostate Cancer Risk: Results from the Prostate Cancer Prevention Trial
Key result
Among 5519 men undergoing prostate biopsy, 21.9% were diagnosed with prostate cancer, with higher PSA, positive family history, and abnormal DRE predicting increased risk.
Population
5,519 men from the placebo group of the Prostate Cancer Prevention Trial who underwent prostate biopsy, had…
Design
Cohort
Authors
Discussion
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Implication
May inform individualized biopsy decisions; leaves open whether risk models reduce overdiagnosis or improve outcomes.
Key Points
- To develop a multivariable risk prediction model integrating clinical risk factors to estimate individualized risk for prostate cancer and high-grade disease.
- Analyzed data from N=5,519 men in the placebo group of the Prostate Cancer Prevention Trial who underwent prostate biopsy with qualifying prior PSA and digital rectal examination (DRE) evaluations.
- Constructed multivariable logistic regression risk equations evaluating age, race, family history, PSA level, PSA velocity, DRE result, and prior biopsy history for predicting overall cancer and high-grade disease (Gleason score ≥7).
- A total of 1,211 of 5,519 men (21.9%) were diagnosed with prostate cancer by prostate biopsy.
- Higher PSA level, positive family history, and abnormal DRE significantly predicted prostate cancer risk, whereas prior negative biopsy was protective; age and PSA velocity provided no independent prognostic value.
- High-grade disease was independently predicted by higher PSA level, abnormal DRE, older age, and African American race, while prior negative biopsy reduced this risk.
Study Design
Type
Observational (n=5,519)
Structured PICO
P
Population
5,519 men from the placebo group of the Prostate Cancer Prevention Trial (PCPT) who underwent prostate biopsy, had at least one PSA measurement and a digital rectal examination (DRE) performed during the year before the biopsy, and had at least two PSA measurements performed during the 3 years before the prostate biopsy.
O
Outcome
Diagnosis of prostate cancer and high-grade disease (Gleason score >=7) by prostate biopsy
A predictive model incorporating clinical variables such as PSA, DRE, family history, and prior biopsy history allows for individualized assessment of prostate cancer risk and high-grade disease.
Cite This Study
Thompson et al. (2006) conducted an observational in Prostate cancer (n=5,519). Predictive model for prostate cancer risk was evaluated on Diagnosis of prostate cancer by prostate biopsy. Among 5519 men undergoing prostate biopsy, 21.9% were diagnosed with prostate cancer, with higher PSA, positive family history, and abnormal DRE predicting increased risk.