title: The impact of prostate volume, number of biopsy cores and American Urological Association symptom score on the sensitivity of cancer detection using the Prostate Cancer Prevention Trial risk calculator.
abstract: OBJECTIVE
  We assessed the independent predictive value of prostate volume, number of biopsy cores and AUASS (American Urological Association symptom score) compared to risk factors included in the PCPTRC (Prostate Cancer Prevention Trial risk calculator for prostate cancer) and PCPTHG (Prostate Cancer Prevention Trial risk calculator for high grade cancer [Gleason grade 7 or greater]).
  
  
  METHODS
  Of 5,519 PCPT (Prostate Cancer Prevention Trial) participants used to construct the PCPTRC 4,958 with AUASS and prostate specific antigen 10 ng/ml or less were included on logistic regression analysis. Risk algorithms were evaluated in 571 EDRN (Early Detection Research Network) participants using the ROC AUC.
  
  
  RESULTS
  A total of 1,094 participants (22.1%) had prostate cancer, of whom 232 (21.2%) had high grade disease. For prostate cancer prediction higher prostate specific antigen, abnormal digital rectal examination, family history of prostate cancer and number of cores were associated with increased risk, while volume was associated with decreased risk. Excluding prostate volume and number of cores, a history of negative biopsy and increased AUASS were also associated with lower risk. For high grade cancer higher prostate specific antigen, abnormal digital rectal examination, black race and number of cores were associated with increased risk and volume, while AUASS was associated with decreased risk. The AUC of the PCPTRC adjusted for volume and number of cores was 72.7% (using EDRN data), 68.2% when adjusted for AUASS alone and 67.6% PCPTRC. For high grade disease the AUCs were 74.8%, 74.0% and 73.5% (PCPTHG), respectively.
  
  
  CONCLUSIONS
  Adjusted PCPT risk calculators for volume, number of cores and AUASS improve cancer detection.
authors: Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA. ankerst@uthscsa.edu
authors: Donna P
authors: DP
authors: Ankerst
authors: Cathee
authors: C
authors: Till
authors: Andreas
authors: A
authors: Boeck
authors: Phyllis
authors: P
authors: Goodman
authors: Catherine M
authors: CM
authors: Tangen
authors: Ziding
authors: Z
authors: Feng
authors: Alan W
authors: AW
authors: Partin
authors: Daniel W
authors: DW
authors: Chan
authors: Lori
authors: L
authors: Sokoll
authors: Jacob
authors: J
authors: Kagan
authors: John T
authors: JT
authors: Wei
authors: Ian M
authors: IM
authors: Thompson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001499:Bayes Theorem; D062005:Biopsy, Large-Core Needle / Q000706:statistics & numerical data; D015331:Cohort Studies; D051517:Digital Rectal Examination; D042241:Early Diagnosis; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000517:prevention & control; D012372:ROC Curve; D012042:Registries; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012955:Societies, Medical; D047368:Tumor Burden / Q000502:physiology*; D014481:United States
chemical_list: D017430:Prostate-Specific Antigen