title: Prostate cancer antigen 3: diagnostic outcomes in men presenting with urinary prostate cancer antigen 3 scores ≥100.
abstract: OBJECTIVE
  To describe the results of 3 rounds of diagnostic testing and linkage to the Dutch Cancer Registry for men with an initial prostate cancer antigen 3 (PCA3) score ≥100.
  
  
  METHODS
  Within an earlier reported comparative study of PCA3 vs prostate-specific antigen in a prescreened population, 90 men with a PCA3 score ≥100 were identified and underwent biopsy, 28 prostate cancers (PCs) were found, 62 men remained at risk of a diagnosis of PC. All men were offered repeat testing; 6 PCs were found in 20 men at rebiopsy. Men with at least 1 negative biopsy (n = 56) were invited to undergo magnetic resonance imaging (MRI) studies and MRI-guided biopsies if indicated. Linkage to the Dutch Cancer Registry after 2.8 years of follow-up was performed for men with negative biopsies.
  
  
  RESULTS
  Of the 56 men at risk, 28 agreed to participate in further testing. They were offered MRI studies; only 7 men agreed, and in 2, suspicious lesions were found and biopsies carried out. Only 1 PC was diagnosed and classified as T1c, Gleason 3 + 3 = 6. The overall findings of 3 rounds of testing and of linkage to the cancer registry show that eventually 35 PCs were detected in 90 men with PCA3 scores ≥100 (positive predictive value 38.9%).
  
  
  CONCLUSIONS
  Finding no PC despite extended diagnostic efforts in many men with initial PCA3 scores ≥100 is unexpected and might be clinically relevant.
authors.affiliation: Department of Urology, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address: secr.schroder@erasmusmc.nl.
authors.forename: Fritz H
authors.initials: FH
authors.lastname: Schröder
authors.affiliation: Department of Urology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Lionne D F
authors.initials: LD
authors.lastname: Venderbos
authors.affiliation: Department of Urology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Roderick C N
authors.initials: RC
authors.lastname: van den Bergh
authors.affiliation: Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Daphne
authors.initials: D
authors.lastname: Hessels
authors.affiliation: Department of Pathology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Geert J L H
authors.initials: GJ
authors.lastname: van Leenders
authors.affiliation: Department of Urology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Pim J
authors.initials: PJ
authors.lastname: van Leeuwen
authors.affiliation: Department of Urology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Tineke
authors.initials: T
authors.lastname: Wolters
authors.affiliation: Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Jelle O
authors.initials: JO
authors.lastname: Barentsz
authors.affiliation: Department of Urology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Monique J
authors.initials: MJ
authors.lastname: Roobol
mesh_terms: D000368:Aged; D000951:Antigens, Neoplasm / Q000652:urine*; D014408:Biomarkers, Tumor / Q000652:urine*; D001706:Biopsy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000652:urine
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; C479341:prostate cancer antigen 3, human