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Prostate Specific Antigen Velocity Does Not Aid Prostate Cancer Detection in Men With Prior Negative Biopsy

Vickers, Andrew J.; Wolters, Tineke; Savage, Caroline J.; Cronin, Angel M.; O'Brien, M. Frank; Roobol, Monique J.; Aus, Gunnar; Scardino, Peter T.; Hugosson, Jonas and Schroder, Fritz H., et al. (2010) In Journal of Urology 184(3). p.907-912
Abstract
Purpose: Prostate specific antigen velocity has been proposed as a marker to aid in prostate cancer detection. We determined whether prostate specific antigen velocity could predict repeat biopsy results in men with persistently increased prostate specific antigen after initial negative biopsy. Materials and Methods: We identified 1,837 men who participated in the Goteborg or Rotterdam section of the European Randomized Screening study of Prostate Cancer and who underwent 1 or more subsequent prostate biopsies after an initial negative finding. We evaluated whether prostate specific antigen velocity improved predictive accuracy beyond that of prostate specific antigen alone. Results: Of the 2,579 repeat biopsies 363 (14%) were positive for... (More)
Purpose: Prostate specific antigen velocity has been proposed as a marker to aid in prostate cancer detection. We determined whether prostate specific antigen velocity could predict repeat biopsy results in men with persistently increased prostate specific antigen after initial negative biopsy. Materials and Methods: We identified 1,837 men who participated in the Goteborg or Rotterdam section of the European Randomized Screening study of Prostate Cancer and who underwent 1 or more subsequent prostate biopsies after an initial negative finding. We evaluated whether prostate specific antigen velocity improved predictive accuracy beyond that of prostate specific antigen alone. Results: Of the 2,579 repeat biopsies 363 (14%) were positive for prostate cancer, of which 44 (1.7%) were high grade (Gleason score 7 or greater). Prostate specific antigen velocity was statistically associated with cancer risk but had low predictive accuracy (AUC 0.55, p <0.001). There was some evidence that prostate specific antigen velocity improved AUC compared to prostate specific antigen for high grade cancer. However, the small increase in risk associated with high prostate specific antigen velocity (from 1.7% to 2.8% as velocity increased from 0 to 1 ng/ml per year) had questionable clinical relevance. Conclusions: Men with prior negative biopsy are at lower risk for prostate cancer at subsequent biopsies with high grade disease particularly rare. We found little evidence to support prostate specific antigen velocity to aid in decisions about repeat biopsy for prostate cancer. (Less)
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Contribution to journal
publication status
published
subject
keywords
prostate-specific antigen, biopsy, prostate, prostatic neoplasms, diagnosis
in
Journal of Urology
volume
184
issue
3
pages
907 - 912
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000280725600025
  • scopus:77956630147
ISSN
1527-3792
DOI
10.1016/j.juro.2010.05.029
language
English
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yes
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3f819b87-fd16-46c1-8d81-6bdc50655d87 (old id 1675409)
date added to LUP
2010-09-22 09:48:51
date last changed
2018-05-29 09:54:35
@article{3f819b87-fd16-46c1-8d81-6bdc50655d87,
  abstract     = {Purpose: Prostate specific antigen velocity has been proposed as a marker to aid in prostate cancer detection. We determined whether prostate specific antigen velocity could predict repeat biopsy results in men with persistently increased prostate specific antigen after initial negative biopsy. Materials and Methods: We identified 1,837 men who participated in the Goteborg or Rotterdam section of the European Randomized Screening study of Prostate Cancer and who underwent 1 or more subsequent prostate biopsies after an initial negative finding. We evaluated whether prostate specific antigen velocity improved predictive accuracy beyond that of prostate specific antigen alone. Results: Of the 2,579 repeat biopsies 363 (14%) were positive for prostate cancer, of which 44 (1.7%) were high grade (Gleason score 7 or greater). Prostate specific antigen velocity was statistically associated with cancer risk but had low predictive accuracy (AUC 0.55, p &lt;0.001). There was some evidence that prostate specific antigen velocity improved AUC compared to prostate specific antigen for high grade cancer. However, the small increase in risk associated with high prostate specific antigen velocity (from 1.7% to 2.8% as velocity increased from 0 to 1 ng/ml per year) had questionable clinical relevance. Conclusions: Men with prior negative biopsy are at lower risk for prostate cancer at subsequent biopsies with high grade disease particularly rare. We found little evidence to support prostate specific antigen velocity to aid in decisions about repeat biopsy for prostate cancer.},
  author       = {Vickers, Andrew J. and Wolters, Tineke and Savage, Caroline J. and Cronin, Angel M. and O'Brien, M. Frank and Roobol, Monique J. and Aus, Gunnar and Scardino, Peter T. and Hugosson, Jonas and Schroder, Fritz H. and Lilja, Hans},
  issn         = {1527-3792},
  keyword      = {prostate-specific antigen,biopsy,prostate,prostatic neoplasms,diagnosis},
  language     = {eng},
  number       = {3},
  pages        = {907--912},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Journal of Urology},
  title        = {Prostate Specific Antigen Velocity Does Not Aid Prostate Cancer Detection in Men With Prior Negative Biopsy},
  url          = {http://dx.doi.org/10.1016/j.juro.2010.05.029},
  volume       = {184},
  year         = {2010},
}