Prostate-specific antigen velocity in a prospective prostate cancer screening study of men with genetic predisposition.
Christos Mikropoulos,
Christina G Hutten Selkirk,
Sibel Saya,
Elizabeth Bancroft,
Emily Vertosick,
Tokhir Dadaev,
Charles Brendler,
Elizabeth Page,
Alexander Dias,
D Gareth Evans,
Jeanette Rothwell,
Lovise Maehle,
Karol Axcrona,
Kate Richardson,
Diana Eccles,
Thomas Jensen,
Palle J Osther,
Christi J van Asperen,
Hans Vasen,
Lambertus A Kiemeney,
Janneke Ringelberg,
Cezary Cybulski,
Dominika Wokolorczyk,
Rachel Hart,
Wayne Glover,
Jimmy Lam,
Louise Taylor,
Monica Salinas,
Lidia Feliubadaló,
Rogier Oldenburg,
Ruben Cremers,
Gerald Verhaegh,
Wendy A van Zelst-Stams,
Jan C Oosterwijk,
Jackie Cook,
Derek J Rosario,
Saundra S Buys,
Tom Conner,
Susan Domchek,
Jacquelyn Powers,
Margreet Gem Ausems,
Manuel R Teixeira,
Sofia Maia,
Louise Izatt,
Rita Schmutzler,
Kerstin Rhiem,
William D Foulkes,
Talia Boshari,
Rosemarie Davidson,
Marielle Ruijs,
Apollonia Tjm Helderman-van den Enden,
Lesley Andrews,
Lisa Walker,
Katie Snape,
Alex Henderson,
Irene Jobson,
Geoffrey J Lindeman,
Annelie Liljegren,
Marion Harris,
Muriel A Adank,
Judy Kirk,
Amy Taylor,
Rachel Susman,
Rakefet Chen-Shtoyerman,
Nicholas Pachter,
Allan Spigelman,
Lucy Side,
Janez Zgajnar,
Josefina Mora,
Carole Brewer,
Neus Gadea,
Angela F Brady,
David Gallagher,
Theo van Os,
Alan Donaldson,
Vigdis Stefansdottir,
Julian Barwell,
Paul A James,
Declan Murphy,
Eitan Friedman,
Nicola Nicolai,
Lynn Greenhalgh,
Elias Obeid,
Vedang Murthy,
Lucia Copakova,
John McGrath,
Soo-Hwang Teo,
Sara Strom,
Karin Kast,
Daniel A Leongamornlert,
Anthony Chamberlain,
Jenny Pope,
Anna C Newlin,
Neil Aaronson,
Audrey Ardern-Jones,
Chris Bangma,
Elena Castro,
David Dearnaley,
Jorunn Eyfjord,
Alison Falconer,
Christopher S Foster,
Henrik Gronberg,
Freddie C Hamdy,
Oskar Johannsson,
Vincent Khoo,
Jan Lubinski,
Eli Marie Grindedal,
Joanne McKinley,
Kylie Shackleton,
Anita V Mitra,
Clare Moynihan,
Gad Rennert,
Mohnish Suri,
Karen Tricker,
,
Sue Moss,
Zsofia Kote-Jarai,
Andrew Vickers,
Hans Lilja,
Brian T Helfand,
Rosalind A Eeles
Abstract
METHODS
PSAV was calculated using logistic regression to determine if PSA or PSAV predicted the result of prostate biopsy (PB) in men with elevated PSA values. Cox regression was used to determine whether PSA or PSAV predicted PSA elevation in men with low PSAs. Interaction terms were included in the models to determine whether BRCA status influenced the predictiveness of PSA or PSAV.
CONCLUSIONS
PSA is more strongly predictive of PrCa in BRCA carriers than non-carriers. We did not find evidence that PSAV aids decision-making for BRCA carriers over absolute PSA value alone.
RESULTS
1634 participants had ⩾3 PSA readings of whom 174 underwent PB and 45 PrCas diagnosed. In men with PSA >3.0 ng ml-l, PSAV was not significantly associated with presence of cancer or high-grade disease. PSAV did not add to PSA for predicting time to an elevated PSA. When comparing BRCA1/2 carriers to non-carriers, we found a significant interaction between BRCA status and last PSA before biopsy (P=0.031) and BRCA2 status and PSAV (P=0.024). However, PSAV was not predictive of biopsy outcome in BRCA2 carriers.
BACKGROUND
Prostate-specific antigen (PSA) and PSA-velocity (PSAV) have been used to identify men at risk of prostate cancer (PrCa). The IMPACT study is evaluating PSA screening in men with a known genetic predisposition to PrCa due to BRCA1/2 mutations. This analysis evaluates the utility of PSA and PSAV for identifying PrCa and high-grade disease in this cohort.