The impact of prostate volume, number of biopsy cores, and AUA symptom score on the sensitivity of cancer detection using the Prostate Cancer Prevention Trial Risk Calculator.

Publication Type:

Journal Article

Source:

The Journal of urology (2013)

Keywords:

February 2013, Public Health Sciences Division

Abstract:

PURPOSE: To assess the independent predictive value of prostate volume, number of biopsy cores, and American Urological Association symptom score (AUASS) to risk factors included in the Prostate Cancer Prevention Trial Risk Calculators for prostate cancer (PCPTRC) and high-grade (Gleason grade ≥ 7) cancer (PCPTHG). MATERIALS AND METHODS: 4958 of 5519 PCPT participants used to construct the PCPTRC/HG with AUASS and PSA ≤ 10 ng/mL were included in a logistic regression analysis; risk algorithms were evaluated on 571 Early Detection Research Network (EDRN) participants using area underneath the receiver operating characteristic curve (AUC). RESULTS: 1094 (22.1%) participants had prostate cancer; 232 (21.2%) of these high-grade disease. For prostate cancer prediction, higher prostate-specific antigen (PSA), abnormal digital rectal exam (DRE), family history of prostate cancer, and number of cores were associated with increased risk and volume with decreased risk. Excluding prostate volume and number of cores, history of a prior negative biopsy and increased AUASS were additionally associated with lower risk. For high-grade cancer, higher PSA, abnormal DRE, African American race and number of cores were associated with increased risk, and volume and AUASS with decreased risk. The AUC of the PCPTRC adjusted for volume and number of cores was 72.5% on the EDRN data, and 68.2% when adjusted for AUASS alone (compared to 67.6% for the PCPTRC); for high-grade disease, AUCs were 74.8% and 74.0%, respectively (compared to 73.5% for the PCPTHG). CONCLUSIONS: Adjusted PCPT Risk Calculators for volume, number of cores and AUASS improve cancer detection.