Predicting Prostate Cancer Risk Through Incorporation of Prostate Cancer Gene 3
Purpose
The online Prostate Cancer Prevention Trial risk calculator combines prostate specific antigen, digital rectal examination, family and biopsy history, age and race to determine the risk of prostate cancer. In this report we incorporate the biomarker prostate cancer gene 3 into the Prostate Cancer Prevention Trial risk calculator.
Materials and Methods
Methodology was developed to incorporate new markers for prostate cancer into the Prostate Cancer Prevention Trial risk calculator based on likelihood ratios calculated from separate case control or cohort studies. The methodology was applied to incorporate the marker prostate cancer gene 3 into the risk calculator based on a cohort of 521 men who underwent prostate biopsy with measurements of urinary prostate cancer gene 3, serum prostate specific antigen, digital rectal examination and biopsy history. External validation of the updated risk calculator was performed on a cohort of 443 European patients, and compared to Prostate Cancer Prevention Trial risks, prostate specific antigen and prostate cancer gene 3 by area underneath the receiver operating characteristic curve, sensitivity and specificity.
Results
The AUC of posterior risks (AUC 0.696, 95% CI 0.641–0.750) was higher than that of prostate specific antigen (AUC 0.607, 95% CI 0.546–0.668, p = 0.001) and Prostate Cancer Prevention Trial risks (AUC 0.653, 95% CI 0.593–0.714, p <0.05). Although it was higher it was not statistically significantly different from that of prostate cancer gene 3 (AUC 0.665, 95% CI 0.610–0.721, p >0.05). Sensitivities of posterior risks were higher than those of prostate cancer gene 3, prostate specific antigen and Prostate Cancer Prevention Trial risks.
Conclusions
New markers for prostate cancer can be incorporated into the Prostate Cancer Prevention Trial risk calculator by a novel approach. Incorporation of prostate cancer gene 3 improved the diagnostic accuracy of the Prostate Cancer Prevention Trial risk calculator.
Key Words: prostate cancer antigen 3, human, likelihood functions, biological markers, prostatic neoplasms, risk assessment
Abbreviations and Acronyms: DRE, digital rectal examination, PCA3, prostate cancer gene 3, PCPT, Prostate Cancer Prevention Trial, PSA, prostate specific antigen
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Supported by the Early Detection Research Network, National Cancer Institute, National Institutes of Health Grant U01-CA86402 and the San Antonio Cancer Institute Grant P30-CA54174.
For another article on a related topic see page 1515.
PII: S0022-5347(08)01570-X
doi:10.1016/j.juro.2008.06.038
© 2008 American Urological Association. Published by Elsevier Inc. All rights reserved.
Refers to article:
- WAVE1 is Associated With Invasiveness and Growth of Prostate Cancer Cells , 19 August 2008
Refers to erratum:
- Erratum , 20 January 2009

