title: PSA doubling time versus PSA velocity to predict high-risk prostate cancer: data from the Baltimore Longitudinal Study of Aging.
abstract: BACKGROUND
  Our group has previously shown that prostate-specific antigen (PSA) velocity (PSAV) is associated with the presence of life-threatening prostate cancer. Less is known about the relative utility of pretreatment PSA doubling time (PSA DT) to predict tumor aggressiveness.
  
  
  OBJECTIVE
  To compare the utility of PSAV and PSA DT for the prediction of life-threatening prostate cancer.
  
  
  METHODS
  From the Baltimore Longitudinal Study of Aging, we identified 681 men with serial PSA measurements.
  
  
  METHODS
  Receiver operating characteristic analysis was used to evaluate the relationship between PSAV, PSA DT, and the presence of high-risk disease.
  
  
  CONCLUSIONS
  Within the period of 5 yr prior to diagnosis, PSAV was significantly higher among men with high-risk or fatal prostate cancer than men without it. By contrast, PSA DT was not significantly associated with high-risk or fatal disease. On multivariate analysis, including age, date of diagnosis, and PSA, the addition of PSAV significantly improved the concordance index from 0.85 to 0.88 (p<0.001), whereas PSA DT did not.
  
  
  CONCLUSIONS
  These data suggest that PSAV is more useful than PSA DT in the pretreatment setting to help identify those men with life-threatening disease.
authors.affiliation: Department of Urology, The Johns Hopkins University School of Medicine, The James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA. stacyloeb@gmail.com
authors.forename: Stacy
authors.initials: S
authors.lastname: Loeb
authors.forename: Anna
authors.initials: A
authors.lastname: Kettermann
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: Patricia
authors.initials: P
authors.lastname: Landis
authors.forename: E Jeffrey
authors.initials: EJ
authors.lastname: Metter
authors.forename: H Ballentine
authors.initials: HB
authors.lastname: Carter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015142:Baltimore / Q000453:epidemiology; D014408:Biomarkers, Tumor / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen