BJUI compass · 2026
The performance of prostate-specific antigen density in long-term prostate cancer-mortality risk prediction.
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Saliba Sara, Kjellman Anders, Thor Anna, Norming Ulf, Lantz Anna, Gustafsson Ove, Lundgren Per-Olof
Аннотация
OBJECTIVE: The objective of this study is to examine whether a baseline calculation of PSAD is associated with prostate cancer-specific mortality after 30 years of follow-up.
METHODS: One-thousand seven-hundred and seventy-nine men were screened for prostate cancer with a PSA test, digital rectal exam (DRE) and ultrasound of the prostate (TRUS). Outcomes, that is, prostate cancer-specific mortality, were extracted from the Swedish National Cause of Death Registry. Hazard ratios for cancer-specific deaths were estimated using Cox proportional hazard regression model. The area under the receiver operating curve (AUC) was determined using logistic regression for men with a baseline PSA in the interval between 3.0 and 10.0 ng/ml.
RESULTS: PSAD was available for 1748 men. Median PSAD was 0.095 ng/ml/cm3 (IQR 0.073-0.14). The age-adjusted hazard ratio for lethal prostate cancer in the cohort of men with PSA between 3.0 and 10.0 ng/ml was 10.1 (95% CI 2.4-42.2) if PSAD was ≥0.15 compared to <0.15.A model including PSAD, palpation and ultrasound findings could distinguish lethal prostate cancer from non-cases at 30 years of follow-up with an AUC of 0.75.
CONCLUSIONS: For men with PSA between 3 and 10 ng/ml, PSAD is a predictor of the long-term risk for lethal prostate cancer. One limitation to this study is the lack of clinical data during follow-up apart from cancer-specific mortality.
METHODS: One-thousand seven-hundred and seventy-nine men were screened for prostate cancer with a PSA test, digital rectal exam (DRE) and ultrasound of the prostate (TRUS). Outcomes, that is, prostate cancer-specific mortality, were extracted from the Swedish National Cause of Death Registry. Hazard ratios for cancer-specific deaths were estimated using Cox proportional hazard regression model. The area under the receiver operating curve (AUC) was determined using logistic regression for men with a baseline PSA in the interval between 3.0 and 10.0 ng/ml.
RESULTS: PSAD was available for 1748 men. Median PSAD was 0.095 ng/ml/cm3 (IQR 0.073-0.14). The age-adjusted hazard ratio for lethal prostate cancer in the cohort of men with PSA between 3.0 and 10.0 ng/ml was 10.1 (95% CI 2.4-42.2) if PSAD was ≥0.15 compared to <0.15.A model including PSAD, palpation and ultrasound findings could distinguish lethal prostate cancer from non-cases at 30 years of follow-up with an AUC of 0.75.
CONCLUSIONS: For men with PSA between 3 and 10 ng/ml, PSAD is a predictor of the long-term risk for lethal prostate cancer. One limitation to this study is the lack of clinical data during follow-up apart from cancer-specific mortality.