Assessment of Prostate-Specific Antigen Doubling Time in Prediction of Prostate Cancer on Needle Biopsy

Stephen Spurgeon, Solange Mongoue-Tchokote, Lauren Collins, Ryan Priest, Yi Ching Hsieh, Laura M. Peters, Tomasz (Tom) Beer, Motomi (Tomi) Mori, Mark Garzotto

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objectives: Prostate-specific antigen (PSA) kinetics have failed to predict for the presence of prostate cancer in screening populations in which many patients harbor subclinical disease. We hypothesized that the prebiopsy PSA doubling time (PSADT) and PSA velocity (PSAV) could predict for cancer detection in a referral population with a suspicion of prostate cancer. Methods: Data were collected from 1699 consecutive veterans with a PSA level of 10 ng/mL or less who underwent prostate biopsy. Logistic regression analysis was performed on the following: age, race, family history, digital rectal examination findings, PSA, PSA density, PSADT, PSAV, prostate volume, and ultrasound lesions. Model building was accomplished with 70% of the data, and validation was done using the remaining 30%. These data were also analyzed using classification and regression tree analysis. Results: Using logistic regression analysis (P 3), digital rectal examination findings, and the presence of a lesion on ultrasonography. A PSADT of 2 to 5 years was marginally associated with prostate cancer detection (odds ratio 1.6, 95% confidence interval 1.1 to 2.3), and a PSADT of less than 2 years or longer than 5 years and PSAV were not predictive. On classification and regression tree analysis, PSADT was not selected as a predictive factor. Furthermore, neither PSADT nor PSAV was predictive of Gleason score 7 or worse cancer. Conclusions: In contrast to its prognostic value after the diagnosis of prostate cancer has been established, PSA kinetics offer little to clinical decision making as predictors of cancer or high-grade cancer in men with a PSA level of 10 ng/mL or less.

Original languageEnglish (US)
Pages (from-to)931-935
Number of pages5
JournalUrology
Volume69
Issue number5
DOIs
StatePublished - May 2007

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Needle Biopsy
Prostate-Specific Antigen
Prostatic Neoplasms
Regression Analysis
Digital Rectal Examination
Prostate
Neoplasms
Logistic Models
Neoplasm Grading
Veterans
Early Detection of Cancer
Population
Ultrasonography
Referral and Consultation
Odds Ratio
Confidence Intervals
Biopsy

ASJC Scopus subject areas

  • Urology

Cite this

Assessment of Prostate-Specific Antigen Doubling Time in Prediction of Prostate Cancer on Needle Biopsy. / Spurgeon, Stephen; Mongoue-Tchokote, Solange; Collins, Lauren; Priest, Ryan; Hsieh, Yi Ching; Peters, Laura M.; Beer, Tomasz (Tom); Mori, Motomi (Tomi); Garzotto, Mark.

In: Urology, Vol. 69, No. 5, 05.2007, p. 931-935.

Research output: Contribution to journalArticle

Spurgeon, Stephen ; Mongoue-Tchokote, Solange ; Collins, Lauren ; Priest, Ryan ; Hsieh, Yi Ching ; Peters, Laura M. ; Beer, Tomasz (Tom) ; Mori, Motomi (Tomi) ; Garzotto, Mark. / Assessment of Prostate-Specific Antigen Doubling Time in Prediction of Prostate Cancer on Needle Biopsy. In: Urology. 2007 ; Vol. 69, No. 5. pp. 931-935.
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abstract = "Objectives: Prostate-specific antigen (PSA) kinetics have failed to predict for the presence of prostate cancer in screening populations in which many patients harbor subclinical disease. We hypothesized that the prebiopsy PSA doubling time (PSADT) and PSA velocity (PSAV) could predict for cancer detection in a referral population with a suspicion of prostate cancer. Methods: Data were collected from 1699 consecutive veterans with a PSA level of 10 ng/mL or less who underwent prostate biopsy. Logistic regression analysis was performed on the following: age, race, family history, digital rectal examination findings, PSA, PSA density, PSADT, PSAV, prostate volume, and ultrasound lesions. Model building was accomplished with 70{\%} of the data, and validation was done using the remaining 30{\%}. These data were also analyzed using classification and regression tree analysis. Results: Using logistic regression analysis (P 3), digital rectal examination findings, and the presence of a lesion on ultrasonography. A PSADT of 2 to 5 years was marginally associated with prostate cancer detection (odds ratio 1.6, 95{\%} confidence interval 1.1 to 2.3), and a PSADT of less than 2 years or longer than 5 years and PSAV were not predictive. On classification and regression tree analysis, PSADT was not selected as a predictive factor. Furthermore, neither PSADT nor PSAV was predictive of Gleason score 7 or worse cancer. Conclusions: In contrast to its prognostic value after the diagnosis of prostate cancer has been established, PSA kinetics offer little to clinical decision making as predictors of cancer or high-grade cancer in men with a PSA level of 10 ng/mL or less.",
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AU - Spurgeon, Stephen

AU - Mongoue-Tchokote, Solange

AU - Collins, Lauren

AU - Priest, Ryan

AU - Hsieh, Yi Ching

AU - Peters, Laura M.

AU - Beer, Tomasz (Tom)

AU - Mori, Motomi (Tomi)

AU - Garzotto, Mark

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N2 - Objectives: Prostate-specific antigen (PSA) kinetics have failed to predict for the presence of prostate cancer in screening populations in which many patients harbor subclinical disease. We hypothesized that the prebiopsy PSA doubling time (PSADT) and PSA velocity (PSAV) could predict for cancer detection in a referral population with a suspicion of prostate cancer. Methods: Data were collected from 1699 consecutive veterans with a PSA level of 10 ng/mL or less who underwent prostate biopsy. Logistic regression analysis was performed on the following: age, race, family history, digital rectal examination findings, PSA, PSA density, PSADT, PSAV, prostate volume, and ultrasound lesions. Model building was accomplished with 70% of the data, and validation was done using the remaining 30%. These data were also analyzed using classification and regression tree analysis. Results: Using logistic regression analysis (P 3), digital rectal examination findings, and the presence of a lesion on ultrasonography. A PSADT of 2 to 5 years was marginally associated with prostate cancer detection (odds ratio 1.6, 95% confidence interval 1.1 to 2.3), and a PSADT of less than 2 years or longer than 5 years and PSAV were not predictive. On classification and regression tree analysis, PSADT was not selected as a predictive factor. Furthermore, neither PSADT nor PSAV was predictive of Gleason score 7 or worse cancer. Conclusions: In contrast to its prognostic value after the diagnosis of prostate cancer has been established, PSA kinetics offer little to clinical decision making as predictors of cancer or high-grade cancer in men with a PSA level of 10 ng/mL or less.

AB - Objectives: Prostate-specific antigen (PSA) kinetics have failed to predict for the presence of prostate cancer in screening populations in which many patients harbor subclinical disease. We hypothesized that the prebiopsy PSA doubling time (PSADT) and PSA velocity (PSAV) could predict for cancer detection in a referral population with a suspicion of prostate cancer. Methods: Data were collected from 1699 consecutive veterans with a PSA level of 10 ng/mL or less who underwent prostate biopsy. Logistic regression analysis was performed on the following: age, race, family history, digital rectal examination findings, PSA, PSA density, PSADT, PSAV, prostate volume, and ultrasound lesions. Model building was accomplished with 70% of the data, and validation was done using the remaining 30%. These data were also analyzed using classification and regression tree analysis. Results: Using logistic regression analysis (P 3), digital rectal examination findings, and the presence of a lesion on ultrasonography. A PSADT of 2 to 5 years was marginally associated with prostate cancer detection (odds ratio 1.6, 95% confidence interval 1.1 to 2.3), and a PSADT of less than 2 years or longer than 5 years and PSAV were not predictive. On classification and regression tree analysis, PSADT was not selected as a predictive factor. Furthermore, neither PSADT nor PSAV was predictive of Gleason score 7 or worse cancer. Conclusions: In contrast to its prognostic value after the diagnosis of prostate cancer has been established, PSA kinetics offer little to clinical decision making as predictors of cancer or high-grade cancer in men with a PSA level of 10 ng/mL or less.

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