OBJECTIVE: Calculation of likelihood ratios for serum prostate-specific antigen (PSA) levels to discriminate potentially curable prostate cancer in men selected for having benign prostatic hyperplasia (BPH) or in randomly selected men. DESIGN: Retrospective analysis of prospectively measured PSA levels. SETTING: A tertiary referral center, a multicenter randomized controlled trial, and a community-based study, all providing PSA data. PATIENTS: We used PSA measurements from four groups of men aged 50 to 79 years: 276 men with organ-confined prostate cancer treated withradical prostatectomy, 305 randomly selected men without clinical evidence of prostate cancer or a history of surgery for BPH recruited for a community study, 173 men without cancer but with BPH coming to prostatectomy, and 770 men without cancer and with symptoms of BPH enrolled in the North American finasteride clinical trial. MEASUREMENTS AND MAIN RESULTS: Age-standardized, stratum-specific likelihood ratios for organ-confined prostate cancer were calculated separately for unselected men in the community sample and for selected men with BPH (pooling both BPH populations). Likelihood ratios ranged from 0.2 for PSA between 0.0 and 2.0 ng/mL to 54.8 for a PSA level of 10.1 ng/mL or higher in unselected men, but rose to only 2.9 for PSA values of 10.1 ng/mL or higher in men with BPH. Forty percent of the men in the community study had moderate to severe lower urinary tract symptoms. In these men, likelihood ratios ranged from 0.2 for PSA values between 0.0 and 2.0 ng/mL to 17.2 for PSA values of 6.1 ng/mL or higher, while in men with no or mild symptoms, likelihood ratios rose to 26.9 for PSA values of 6.1 ng/mL or higher. CONCLUSIONS:Likelihood ratios for PSA test results allow stratification of men along a continuum of risk for prostate cancer. Likelihood ratios demonstrate that the ability of the PSA test to discriminate potentially curable prostate cancer from BPH is dramatically lower in men selected with lower urinary tract symptoms than in randomly selected men.
RCT Entities:
OBJECTIVE: Calculation of likelihood ratios for serum prostate-specific antigen (PSA) levels to discriminate potentially curable prostate cancer in men selected for having benign prostatic hyperplasia (BPH) or in randomly selected men. DESIGN: Retrospective analysis of prospectively measured PSA levels. SETTING: A tertiary referral center, a multicenter randomized controlled trial, and a community-based study, all providing PSA data. PATIENTS: We used PSA measurements from four groups of men aged 50 to 79 years: 276 men with organ-confined prostate cancer treated with radical prostatectomy, 305 randomly selected men without clinical evidence of prostate cancer or a history of surgery for BPH recruited for a community study, 173 men without cancer but with BPH coming to prostatectomy, and 770 men without cancer and with symptoms of BPH enrolled in the North American finasteride clinical trial. MEASUREMENTS AND MAIN RESULTS: Age-standardized, stratum-specific likelihood ratios for organ-confined prostate cancer were calculated separately for unselected men in the community sample and for selected men with BPH (pooling both BPH populations). Likelihood ratios ranged from 0.2 for PSA between 0.0 and 2.0 ng/mL to 54.8 for a PSA level of 10.1 ng/mL or higher in unselected men, but rose to only 2.9 for PSA values of 10.1 ng/mL or higher in men with BPH. Forty percent of the men in the community study had moderate to severe lower urinary tract symptoms. In these men, likelihood ratios ranged from 0.2 for PSA values between 0.0 and 2.0 ng/mL to 17.2 for PSA values of 6.1 ng/mL or higher, while in men with no or mild symptoms, likelihood ratios rose to 26.9 for PSA values of 6.1 ng/mL or higher. CONCLUSIONS: Likelihood ratios for PSA test results allow stratification of men along a continuum of risk for prostate cancer. Likelihood ratios demonstrate that the ability of the PSA test to discriminate potentially curable prostate cancer from BPH is dramatically lower in men selected with lower urinary tract symptoms than in randomly selected men.
Authors: S J Jacobsen; S K Katusic; E J Bergstralh; J E Oesterling; D Ohrt; G G Klee; C G Chute; M M Lieber Journal: JAMA Date: 1995-11-08 Impact factor: 56.272
Authors: William J Catalona; Jerome P Richie; Frederick R Ahmann; M'Liss A Hudson; Peter T Scardino; Robert C Flanigan; Jean B DeKernion; Timothy L Ratliff; Louis R Kavoussi; Bruce L Dalkin; W Bedford Waters; Michael T MacFarlane; Paula C Southwick Journal: J Urol Date: 1994-05 Impact factor: 7.450
Authors: Christian J Konopka; Marcin Woźniak; Jamila Hedhli; Anna Siekierzycka; Jarosław Skokowski; Rafał Pęksa; Marcin Matuszewski; Gnanasekar Munirathinam; Andre Kajdacsy-Balla; Iwona T Dobrucki; Leszek Kalinowski; Lawrence W Dobrucki Journal: Eur J Nucl Med Mol Imaging Date: 2020-03-12 Impact factor: 9.236
Authors: Amar Bhindi; Bimal Bhindi; Girish S Kulkarni; Robert J Hamilton; Ants Toi; Theodorus H van der Kwast; Andrew Evans; Alexandre R Zlotta; Antonio Finelli; Neil E Fleshner Journal: Can Urol Assoc J Date: 2017 Jan-Feb Impact factor: 1.862
Authors: Matthew J Watson; Arvin K George; Mahir Maruf; Thomas P Frye; Akhil Muthigi; Michael Kongnyuy; Subin G Valayil; Peter A Pinto Journal: Future Oncol Date: 2016-07-12 Impact factor: 3.404
Authors: Daniel I Glazer; William W Mayo-Smith; Nisha I Sainani; Cheryl A Sadow; Mark G Vangel; Clare M Tempany; Ruth M Dunne Journal: AJR Am J Roentgenol Date: 2017-06-28 Impact factor: 3.959
Authors: M Maruf; M Fascelli; A K George; M M Siddiqui; M Kongnyuy; J M DiBianco; A Muthigi; S Valayil; A Sidana; T P Frye; A Kilchevsky; P L Choyke; B Turkbey; B J Wood; P A Pinto Journal: Prostate Cancer Prostatic Dis Date: 2017-02-21 Impact factor: 5.554
Authors: Jeannette M Schenk; Alan R Kristal; Kathryn B Arnold; Catherine M Tangen; Marian L Neuhouser; Daniel W Lin; Emily White; Ian M Thompson Journal: Am J Epidemiol Date: 2011-05-03 Impact factor: 4.897
Authors: Howard B Lieberman; Alex J Rai; Richard A Friedman; Kevin M Hopkins; Constantinos G Broustas Journal: Transl Cancer Res Date: 2018-01-14 Impact factor: 1.241