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Prostate Specific Antigen Velocity Does Not Aid Prostate Cancer Detection in Men With Prior Negative Biopsy

På svenska

Author

  • 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. Schroder
  • Hans Lilja
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Summary, in English

Purpose: Prostate specific antigen velocity has been proposed as a marker to aid in prostate cancer detection. We determined whether prostate specific antigen velocity could predict repeat biopsy results in men with persistently increased prostate specific antigen after initial negative biopsy. Materials and Methods: We identified 1,837 men who participated in the Goteborg or Rotterdam section of the European Randomized Screening study of Prostate Cancer and who underwent 1 or more subsequent prostate biopsies after an initial negative finding. We evaluated whether prostate specific antigen velocity improved predictive accuracy beyond that of prostate specific antigen alone. Results: Of the 2,579 repeat biopsies 363 (14%) were positive for prostate cancer, of which 44 (1.7%) were high grade (Gleason score 7 or greater). Prostate specific antigen velocity was statistically associated with cancer risk but had low predictive accuracy (AUC 0.55, p <0.001). There was some evidence that prostate specific antigen velocity improved AUC compared to prostate specific antigen for high grade cancer. However, the small increase in risk associated with high prostate specific antigen velocity (from 1.7% to 2.8% as velocity increased from 0 to 1 ng/ml per year) had questionable clinical relevance. Conclusions: Men with prior negative biopsy are at lower risk for prostate cancer at subsequent biopsies with high grade disease particularly rare. We found little evidence to support prostate specific antigen velocity to aid in decisions about repeat biopsy for prostate cancer.

Publishing year

2010

Language

English

Pages

907-912

Publication/Series

Journal of Urology

Volume

184

Issue

3

Document type

Journal article

Publisher

Lippincott Williams & Wilkins

Topic

  • Urology and Nephrology

Keywords

  • prostate-specific antigen
  • biopsy
  • prostate
  • prostatic neoplasms
  • diagnosis

Status

Published

Research group

  • Clinical Chemistry, Malmö

ISBN/ISSN/Other

  • ISSN: 1527-3792