Contribution of a single repeat PSA test to prostate cancer risk assessment: experience from the ProtecT study.
OBJECTIVE: To examine whether a single repeat prostate-specific antigen (PSA) helps discriminate cancer from non-cancer-related PSA elevation. METHODS: Men aged 50-70 yr (n=54,087) in a multicentre randomised controlled trial comparing treatments for localised prostate cancer were tested. A total of...
| Main Authors: | , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2008
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| _version_ | 1797074100549582848 |
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| author | Rosario, D Lane, J Metcalfe, C Catto, J Dedman, D Donovan, J Neal, D Hamdy, F |
| author_facet | Rosario, D Lane, J Metcalfe, C Catto, J Dedman, D Donovan, J Neal, D Hamdy, F |
| author_sort | Rosario, D |
| collection | OXFORD |
| description | OBJECTIVE: To examine whether a single repeat prostate-specific antigen (PSA) helps discriminate cancer from non-cancer-related PSA elevation. METHODS: Men aged 50-70 yr (n=54,087) in a multicentre randomised controlled trial comparing treatments for localised prostate cancer were tested. A total of 4102 (7.6%) with an initial PSA in the range of 3-19.9 ng/ml had repeat measurement (median interval: 50 d) followed by prostate biopsy. The decision to biopsy was based on the first PSA level. The outcome was the presence of prostate cancer on biopsy. RESULTS: Men with a 20% drop in PSA had a lower risk of cancer (odds ratio [OR]=0.43; 95% confidence interval [CI], 0.35-0.52; p<0.001) and high-grade cancer (OR=0.29; 95%CI, 0.19-0.44; p<0.001) compared to the rest of the cohort. The effect of percentage reduction was greater in men aged < or =60 yr than in those >60 yr. (OR for any cancer=1.6; 95%CI, 1.0-2.4; p=0.05; OR for high-grade cancer=2.9; 95%CI, 1.2-6.7; p=0.014). This equated to a risk reduction of high-grade cancer from 4% to 0.5%, 6% to 2%, and 15% to 2% in men < or =60 yr with an initial PSA of 3.0-3.99, 4.0-5.99, and > or =6 ng/ml, respectively. No level of repeat PSA confidently predicted absence of cancer. CONCLUSION: Following an initial PSA of 3.0-19.99 ng/ml in men aged 50-70 yr, repeat PSA within 7 wk allows more accurate risk prediction that may assist in the decision-making as to whether or not to proceed with prostate biopsy. |
| first_indexed | 2024-03-06T23:31:27Z |
| format | Journal article |
| id | oxford-uuid:6c296ca6-6bab-4718-9ce9-7b1e346147ca |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:31:27Z |
| publishDate | 2008 |
| record_format | dspace |
| spelling | oxford-uuid:6c296ca6-6bab-4718-9ce9-7b1e346147ca2022-03-26T19:09:03ZContribution of a single repeat PSA test to prostate cancer risk assessment: experience from the ProtecT study.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6c296ca6-6bab-4718-9ce9-7b1e346147caEnglishSymplectic Elements at Oxford2008Rosario, DLane, JMetcalfe, CCatto, JDedman, DDonovan, JNeal, DHamdy, FOBJECTIVE: To examine whether a single repeat prostate-specific antigen (PSA) helps discriminate cancer from non-cancer-related PSA elevation. METHODS: Men aged 50-70 yr (n=54,087) in a multicentre randomised controlled trial comparing treatments for localised prostate cancer were tested. A total of 4102 (7.6%) with an initial PSA in the range of 3-19.9 ng/ml had repeat measurement (median interval: 50 d) followed by prostate biopsy. The decision to biopsy was based on the first PSA level. The outcome was the presence of prostate cancer on biopsy. RESULTS: Men with a 20% drop in PSA had a lower risk of cancer (odds ratio [OR]=0.43; 95% confidence interval [CI], 0.35-0.52; p<0.001) and high-grade cancer (OR=0.29; 95%CI, 0.19-0.44; p<0.001) compared to the rest of the cohort. The effect of percentage reduction was greater in men aged < or =60 yr than in those >60 yr. (OR for any cancer=1.6; 95%CI, 1.0-2.4; p=0.05; OR for high-grade cancer=2.9; 95%CI, 1.2-6.7; p=0.014). This equated to a risk reduction of high-grade cancer from 4% to 0.5%, 6% to 2%, and 15% to 2% in men < or =60 yr with an initial PSA of 3.0-3.99, 4.0-5.99, and > or =6 ng/ml, respectively. No level of repeat PSA confidently predicted absence of cancer. CONCLUSION: Following an initial PSA of 3.0-19.99 ng/ml in men aged 50-70 yr, repeat PSA within 7 wk allows more accurate risk prediction that may assist in the decision-making as to whether or not to proceed with prostate biopsy. |
| spellingShingle | Rosario, D Lane, J Metcalfe, C Catto, J Dedman, D Donovan, J Neal, D Hamdy, F Contribution of a single repeat PSA test to prostate cancer risk assessment: experience from the ProtecT study. |
| title | Contribution of a single repeat PSA test to prostate cancer risk assessment: experience from the ProtecT study. |
| title_full | Contribution of a single repeat PSA test to prostate cancer risk assessment: experience from the ProtecT study. |
| title_fullStr | Contribution of a single repeat PSA test to prostate cancer risk assessment: experience from the ProtecT study. |
| title_full_unstemmed | Contribution of a single repeat PSA test to prostate cancer risk assessment: experience from the ProtecT study. |
| title_short | Contribution of a single repeat PSA test to prostate cancer risk assessment: experience from the ProtecT study. |
| title_sort | contribution of a single repeat psa test to prostate cancer risk assessment experience from the protect study |
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