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Free PSA and Clinic...
Free PSA and Clinically Significant and Fatal Prostate Cancer in the PLCO Screening Trial
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- Yim, Kendrick (author)
- Brigham and Women's Hospital / Harvard Medical School
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- Ma, Chaoran (author)
- Brigham and Women's Hospital / Harvard Medical School
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- Carlsson, Sigrid (author)
- University of Gothenburg,Sahlgrenska Academy,Memorial Sloan-Kettering Cancer Center
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- Lilja, Hans (author)
- Lund University,Lunds universitet,Klinisk kemi, Malmö,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Clinical Chemistry, Malmö,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Memorial Sloan-Kettering Cancer Center
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- Mucci, Lorelei (author)
- Harvard T.H. Chan School of Public Health
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- Penney, Kathryn (author)
- Brigham and Women's Hospital / Harvard Medical School,Harvard T.H. Chan School of Public Health
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- Kibel, Adam S (author)
- Brigham and Women's Hospital / Harvard Medical School
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- Eggener, Scott (author)
- University of Chicago
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- Preston, Mark A (author)
- Brigham and Women's Hospital / Harvard Medical School
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(creator_code:org_t)
- 2023
- 2023
- English.
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In: The Journal of urology. - 1527-3792. ; 210:4, s. 630-638
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http://dx.doi.org/10...
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Abstract
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- INTRODUCTION: We studied whether adding percent free prostate-specific antigen (%fPSA) to total PSA improves prediction of clinically significant prostate cancer (csPCa) and fatal PCa.METHODS: 6727 men within the intervention arm of the Prostate, Lung, Colorectal and Ovarian Trial had baseline %fPSA. Of this cohort, 475 had csPCa and 98 had fatal PCa. Cumulative incidence and Cox analyses were conducted to evaluate the association between %fPSA/PSA and csPCa/fatal PCa. Harrell's concordance-index (C-index) evaluated predictive ability. Kaplan-Meier analysis assessed survival.RESULTS: Median follow-up was 19.7 years, median baseline PSA was 1.19 ng/mL, median %fPSA was 18%. Cumulative incidence of fatal PCa for men with baseline PSA≥2 ng/mL and %fPSA ≤10 was 3.2% and 6.1% at 15 and 25 years, compared to 0.03% and 1.1% for men with %fPSA >25%. In younger men (55-64 yr) with baseline PSA 2-10 ng/mL, C-index improved from 0.56 to 0.60 for csPCa and from 0.53 to 0.64 for fatal PCa with addition of %fPSA. In older men (65-74 yr), C-index improved for csPCa from 0.60 to 0.66, while no improvement in fatal PCa. Adjusting for age, digital rectal exam, family history of PCa, and total PSA, %fPSA was associated with csPCa (HR 1.05, P < .001) per 1% decrease. %fPSA improved prediction of csPCa and fatal PCA for all race groups. CONCLUSION: In a large US screening trial, the addition of %fPSA to total PSA in men with baseline PSA ≥2 ng/mL improved prediction of csPCa and fatal PCa. Free PSA should be used to risk-stratify screening and decrease unnecessary prostate biopsies.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Publication and Content Type
- art (subject category)
- ref (subject category)
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