PURPOSE: It has been suggested that prostate specific antigen has no predictive value for prostate cancer after a first negative biopsy has been performed. We compared the performance operating characteristics of prostate specific antigen for prostate cancer between a first and subsequent prostate biopsy in a group of men with complete verification of cancer status. MATERIALS AND METHODS: From the 18,882 participants in the Prostate Cancer Prevention Trial we examined men in the placebo group who had only a first biopsy or a first and second prostate biopsy with a prostate specific antigen and digital rectal examination within 1 year before each biopsy. The receiver operating characteristic curve was estimated for prostate specific antigen for detection of prostate cancer on the first biopsy compared to the second, and the C-statistics were compared. RESULTS: Of this group 5,608 men had a first biopsy and 687 of those with a negative first biopsy underwent a second biopsy. The C-statistic was 0.650 (95% CI 0.632, 0.668) for the first biopsy and 0.664 (95% CI 0.607, 0.721) for the second biopsy. The C-statistic for the second biopsy was statistically significantly greater than 0.5 (p <0.001) and overlapped with that from the first biopsy. CONCLUSIONS: Prostate specific antigen does not lose predictive value for the detection of prostate cancer even after a first biopsy shows no evidence of cancer, and its performance characteristics are only slightly decreased.
RCT Entities:
PURPOSE: It has been suggested that prostate specific antigen has no predictive value for prostate cancer after a first negative biopsy has been performed. We compared the performance operating characteristics of prostate specific antigen for prostate cancer between a first and subsequent prostate biopsy in a group of men with complete verification of cancer status. MATERIALS AND METHODS: From the 18,882 participants in the Prostate Cancer Prevention Trial we examined men in the placebo group who had only a first biopsy or a first and second prostate biopsy with a prostate specific antigen and digital rectal examination within 1 year before each biopsy. The receiver operating characteristic curve was estimated for prostate specific antigen for detection of prostate cancer on the first biopsy compared to the second, and the C-statistics were compared. RESULTS: Of this group 5,608 men had a first biopsy and 687 of those with a negative first biopsy underwent a second biopsy. The C-statistic was 0.650 (95% CI 0.632, 0.668) for the first biopsy and 0.664 (95% CI 0.607, 0.721) for the second biopsy. The C-statistic for the second biopsy was statistically significantly greater than 0.5 (p <0.001) and overlapped with that from the first biopsy. CONCLUSIONS:Prostate specific antigen does not lose predictive value for the detection of prostate cancer even after a first biopsy shows no evidence of cancer, and its performance characteristics are only slightly decreased.
Authors: Andrew J Vickers; Tineke Wolters; Caroline J Savage; Angel M Cronin; M Frank O'Brien; Monique J Roobol; Gunnar Aus; Peter T Scardino; Jonas Hugosson; Fritz H Schröder; Hans Lilja Journal: J Urol Date: 2010-09 Impact factor: 7.450
Authors: Paul J Newcombe; Brian H Reck; Jielin Sun; Greg T Platek; Claudio Verzilli; A Karim Kader; Seong-Tae Kim; Fang-Chi Hsu; Zheng Zhang; S Lilly Zheng; Vincent E Mooser; Lynn D Condreay; Colin F Spraggs; John C Whittaker; Roger S Rittmaster; Jianfeng Xu Journal: Genet Epidemiol Date: 2012-01 Impact factor: 2.135
Authors: Alan W Partin; Leander Van Neste; Eric A Klein; Leonard S Marks; Jason R Gee; Dean A Troyer; Kimberly Rieger-Christ; J Stephen Jones; Cristina Magi-Galluzzi; Leslie A Mangold; Bruce J Trock; Raymond S Lance; Joseph W Bigley; Wim Van Criekinge; Jonathan I Epstein Journal: J Urol Date: 2014-04-18 Impact factor: 7.450