Predicting prostate cancer risk through incorporation of prostate cancer gene 3.
OBJECTIVE
The online Prostate Cancer Prevention Trial risk calculator combines prostate specific antigen, digital rectal examination, family and biopsy history, age and race to determine the risk of prostate cancer. In this report we incorporate the biomarker prostate cancer gene 3 into the Prostate Cancer Prevention Trial risk calculator.


METHODS
Methodology was developed to incorporate new markers for prostate cancer into the Prostate Cancer Prevention Trial risk calculator based on likelihood ratios calculated from separate case control or cohort studies. The methodology was applied to incorporate the marker prostate cancer gene 3 into the risk calculator based on a cohort of 521 men who underwent prostate biopsy with measurements of urinary prostate cancer gene 3, serum prostate specific antigen, digital rectal examination and biopsy history. External validation of the updated risk calculator was performed on a cohort of 443 European patients, and compared to Prostate Cancer Prevention Trial risks, prostate specific antigen and prostate cancer gene 3 by area underneath the receiver operating characteristic curve, sensitivity and specificity.


RESULTS
The AUC of posterior risks (AUC 0.696, 95% CI 0.641-0.750) was higher than that of prostate specific antigen (AUC 0.607, 95% CI 0.546-0.668, p = 0.001) and Prostate Cancer Prevention Trial risks (AUC 0.653, 95% CI 0.593-0.714, p <0.05). Although it was higher it was not statistically significantly different from that of prostate cancer gene 3 (AUC 0.665, 95% CI 0.610-0.721, p >0.05). Sensitivities of posterior risks were higher than those of prostate cancer gene 3, prostate specific antigen and Prostate Cancer Prevention Trial risks.


CONCLUSIONS
New markers for prostate cancer can be incorporated into the Prostate Cancer Prevention Trial risk calculator by a novel approach. Incorporation of prostate cancer gene 3 improved the diagnostic accuracy of the Prostate Cancer Prevention Trial risk calculator.
Ankerst
Donna Pauler
DP
Department of Urology, University of Texas Health Sciences Center, San Antonio, Texas 78229, USA. ankerst@uthscsa.edu
Groskopf
Jack
J
Day
John R
JR
Blase
Amy
A
Rittenhouse
Harry
H
Pollock
Brad H
BH
Tangen
Cathy
C
Parekh
Dipen
D
Leach
Robin J
RJ
Thompson
Ian
I
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000032:analysis*; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000032:analysis*; D001707:Biopsy, Needle; D016022:Case-Control Studies; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D016001:Confidence Intervals; D015972:Gene Expression Regulation, Neoplastic; D005819:Genetic Markers; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011322:Primary Prevention; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000032:analysis*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics* / Q000473:pathology / Q000517:prevention & control; D018570:Risk Assessment; D016019:Survival Analysis
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D005819:Genetic Markers; C479341:prostate cancer antigen 3, human; D017430:Prostate-Specific Antigen