Selective detection of histologically aggressive prostate cancer
dc.contributor.author | Williams, Stephen B. | en_US |
dc.contributor.author | Salami, Simpa | en_US |
dc.contributor.author | Regan, Meredith M. | en_US |
dc.contributor.author | Ankerst, Donna P. | en_US |
dc.contributor.author | Wei, John T. | en_US |
dc.contributor.author | Rubin, Mark A. | en_US |
dc.contributor.author | Thompson, Ian M. | en_US |
dc.contributor.author | Sanda, Martin G. | en_US |
dc.date.accessioned | 2012-05-21T15:47:22Z | |
dc.date.available | 2013-07-01T14:33:05Z | en_US |
dc.date.issued | 2012-05-15 | en_US |
dc.identifier.citation | Williams, Stephen B.; Salami, Simpa; Regan, Meredith M.; Ankerst, Donna P.; Wei, John T.; Rubin, Mark A.; Thompson, Ian M.; Sanda, Martin G. (2012). "Selective detection of histologically aggressive prostate cancer ." Cancer 118(10): 2651-2658. <http://hdl.handle.net/2027.42/91121> | en_US |
dc.identifier.issn | 0008-543X | en_US |
dc.identifier.issn | 1097-0142 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/91121 | |
dc.description.abstract | BACKGROUND: Limited survival benefit and excess treatment because of prostate‐specific antigen (PSA) screening in randomized trials suggests a need for more restricted selection of prostate biopsy candidates by discerning risk of histologically aggressive versus indolent cancer before biopsy. METHODS: Subjects undergoing first prostate biopsy enrolled in a multicenter, prospective cohort of the National Cancer Institute Early Detection Research Network (N = 635) were analyzed to develop a model for predicting histologically aggressive prostate cancers. The control arm of the Prostate Cancer Prevention Trial (N = 3833) was used to validate the generalization of the predictive model. RESULTS: The Early Detection Research Network cohort was comprised of men among whom 57% had no cancer, 14% had indolent cancer, and 29% had aggressive cancer. Age, body mass index, family history of prostate cancer, abnormal digital rectal examination (DRE), and PSA density (PSAD) were associated with aggressive cancer (all P < .001). The Early Detection Research Network model outperformed PSA alone in predicting aggressive cancer (area under the curve [AUC] = 0.81 vs 0.71, P < .01). Model validation in the Prostate Cancer Prevention Trial cohort accurately identified men at low (<10%) risk of aggressive cancer for whom biopsy could be averted (AUC = 0.78; 95% confidence interval, 0.75‐0.80). Under criteria from the Early Detection Research Network model, prostate biopsy can be restricted to men with PSAD >0.1 ng/mL/cc or abnormal DRE. When PSAD is <0.1 ng/mL/cc, family history or obesity can identify biopsy candidates. CONCLUSIONS: A predictive model incorporating age, family history, obesity, PSAD, and DRE elucidates criteria whereby ¼ of prostate biopsies can be averted while retaining high sensitivity in detecting aggressive prostate cancer. Cancer 2011. © 2011 American Cancer Society. A predictive model incorporating age, family history, obesity, prostate‐specific antigen density, and digital rectal examination has been proposed in detecting aggressive prostate cancer. Using these criteria, ¼ of prostate biopsies can be avoided. | en_US |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.subject.other | Indolent | en_US |
dc.subject.other | Prostate Cancer | en_US |
dc.subject.other | Biopsy | en_US |
dc.subject.other | Clinically Significant | en_US |
dc.title | Selective detection of histologically aggressive prostate cancer | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Oncology and Hematology | en_US |
dc.subject.hlbsecondlevel | Public Health | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Urology, University of Michigan, Ann Arbor, Michigan | en_US |
dc.contributor.affiliationother | 330 Brookline Ave, Rabb 440, Division of Urology, BIDMC, Boston, MA 20115 | en_US |
dc.contributor.affiliationother | Division of Urology, Beth Israel Deaconess Medical Center, Boston, Massachusetts | en_US |
dc.contributor.affiliationother | Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts | en_US |
dc.contributor.affiliationother | Harvard Medical School, Boston, Massachusetts | en_US |
dc.contributor.affiliationother | Department of Biostatistics and Computational Biology, Dana‐Farber Cancer Institute, Boston, Massachusetts | en_US |
dc.contributor.affiliationother | University of Texas Health Science Center at San Antonio, San Antonio, Texas | en_US |
dc.contributor.affiliationother | Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York | en_US |
dc.identifier.pmid | 22006057 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/91121/1/26396_ftp.pdf | |
dc.identifier.doi | 10.1002/cncr.26396 | en_US |
dc.identifier.source | Cancer | en_US |
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dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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