The relationship between prostate-specific antigen and prostate cancer risk

The prostate biopsy collaborative group

Andrew J. Vickers, Angel M. Cronin, Monique J. Roobol, Jonas Hugosson, J. Stephen Jones, Michael W. Kattan, Eric Klein, Freddie Hamdy, David Neal, Jenny Donovan, Dipen J Parekh, Donna Ankerst, George Bartsch, Helmut Klocker, Wolfgang Horninger, Amine Benchikh, Gilles Salama, Arnauld Villers, Steve J. Freedland, Daniel M. Moreira & 2 others Fritz H. Schröder, Hans Lilja

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Purpose: The relationship between prostate-specific antigen (PSA) level and prostate cancer risk remains subject to fundamental disagreements. We hypothesized that the risk of prostate cancer on biopsy for a given PSA level is affected by identifiable characteristics of the cohort under study. Experimental Design: We used data from five European and three U.S. cohorts of men undergoing biopsy for prostate cancer; six were population-based studies and two were clinical cohorts. The association between PSA and prostate cancer was calculated separately for each cohort using locally weighted scatterplot smoothing. Results: The final data set included 25,772 biopsies and 8,503 cancers. There were gross disparities between cohorts with respect to both the prostate cancer risk at a given PSA level and the shape of the risk curve. These disparities were associated with identifiable differences between cohorts: for a given PSA level, a greater number of biopsy cores increased the risk of cancer (odds ratio for >6- versus 6-core biopsy, 1.35; 95% confidence interval, 1.18-1.54; P < 0.0005); recent screening led to a smaller increase in risk per unit change in PSA (P = 0.001 for interaction term) and U.S. cohorts had higher risk than the European cohorts (2.14; 95% confidence interval, 1.99-2.30; P < 0.0005). Conclusions: Our results suggest that the relationship between PSA and risk of a positive prostate biopsy varies, both in terms of the probability of prostate cancer at a given PSA value and the shape of the risk curve. This poses challenges to the use of PSA-driven algorithms to determine whether biopsy is indicated.

Original languageEnglish
Pages (from-to)4374-4381
Number of pages8
JournalClinical Cancer Research
Volume16
Issue number17
DOIs
StatePublished - Sep 1 2010
Externally publishedYes

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Prostate-Specific Antigen
Prostate
Prostatic Neoplasms
Biopsy
Confidence Intervals
Neoplasms
Cohort Studies
Research Design
Odds Ratio

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Vickers, A. J., Cronin, A. M., Roobol, M. J., Hugosson, J., Jones, J. S., Kattan, M. W., ... Lilja, H. (2010). The relationship between prostate-specific antigen and prostate cancer risk: The prostate biopsy collaborative group. Clinical Cancer Research, 16(17), 4374-4381. https://doi.org/10.1158/1078-0432.CCR-10-1328

The relationship between prostate-specific antigen and prostate cancer risk : The prostate biopsy collaborative group. / Vickers, Andrew J.; Cronin, Angel M.; Roobol, Monique J.; Hugosson, Jonas; Jones, J. Stephen; Kattan, Michael W.; Klein, Eric; Hamdy, Freddie; Neal, David; Donovan, Jenny; Parekh, Dipen J; Ankerst, Donna; Bartsch, George; Klocker, Helmut; Horninger, Wolfgang; Benchikh, Amine; Salama, Gilles; Villers, Arnauld; Freedland, Steve J.; Moreira, Daniel M.; Schröder, Fritz H.; Lilja, Hans.

In: Clinical Cancer Research, Vol. 16, No. 17, 01.09.2010, p. 4374-4381.

Research output: Contribution to journalArticle

Vickers, AJ, Cronin, AM, Roobol, MJ, Hugosson, J, Jones, JS, Kattan, MW, Klein, E, Hamdy, F, Neal, D, Donovan, J, Parekh, DJ, Ankerst, D, Bartsch, G, Klocker, H, Horninger, W, Benchikh, A, Salama, G, Villers, A, Freedland, SJ, Moreira, DM, Schröder, FH & Lilja, H 2010, 'The relationship between prostate-specific antigen and prostate cancer risk: The prostate biopsy collaborative group', Clinical Cancer Research, vol. 16, no. 17, pp. 4374-4381. https://doi.org/10.1158/1078-0432.CCR-10-1328
Vickers, Andrew J. ; Cronin, Angel M. ; Roobol, Monique J. ; Hugosson, Jonas ; Jones, J. Stephen ; Kattan, Michael W. ; Klein, Eric ; Hamdy, Freddie ; Neal, David ; Donovan, Jenny ; Parekh, Dipen J ; Ankerst, Donna ; Bartsch, George ; Klocker, Helmut ; Horninger, Wolfgang ; Benchikh, Amine ; Salama, Gilles ; Villers, Arnauld ; Freedland, Steve J. ; Moreira, Daniel M. ; Schröder, Fritz H. ; Lilja, Hans. / The relationship between prostate-specific antigen and prostate cancer risk : The prostate biopsy collaborative group. In: Clinical Cancer Research. 2010 ; Vol. 16, No. 17. pp. 4374-4381.
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AU - Hugosson, Jonas

AU - Jones, J. Stephen

AU - Kattan, Michael W.

AU - Klein, Eric

AU - Hamdy, Freddie

AU - Neal, David

AU - Donovan, Jenny

AU - Parekh, Dipen J

AU - Ankerst, Donna

AU - Bartsch, George

AU - Klocker, Helmut

AU - Horninger, Wolfgang

AU - Benchikh, Amine

AU - Salama, Gilles

AU - Villers, Arnauld

AU - Freedland, Steve J.

AU - Moreira, Daniel M.

AU - Schröder, Fritz H.

AU - Lilja, Hans

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