An examination of the dynamic changes in prostate-specific antigen occurring in a population-based cohort of men over time.


Journal Article

OBJECTIVE: • To determine whether prostate-specific antigen velocity (PSA-V), PSA doubling time (PSA-DT), or PSA percentage change (PSA-PC) add incremental information to PSA alone for community-based men undergoing prostate cancer (PCa) screening. PARTICIPANTS AND METHODS: • A population-based cohort of 11 872 men from Olmsted County, MN undergoing PSA screening for PCa from 1993 to 2005 was analysed for PSA, PSA-DT, PSA-PC and PSA-V and subsequent PCa. • Receiver-operating characteristics curves and logistic regression were used to calculate the area under the curve (AUC) and Aikaike's information criterion. • Reclassification analysis was performed and the net reclassification improvement and integrated discrimination improvement were measured. • The method of Begg and Greenes was used to adjust for verification bias. RESULTS: • The single best predictor of future PCa was PSA (AUC = 0.773) with PSA-V (AUC = 0.729) and PSA-DT/PSA-PC (AUC = 0.689) performing worse. • After age adjustment, combining PSA with PSA-V (AUC = 0.773) or PSA-DT/PSA-PC (AUC = 0.773) resulted in no better predictions than PSA alone. • Reclassification analysis showed that adding PSA-V or PSA-DT/PSA-PC to PSA did not result in a meaningful amount of reclassification. CONCLUSIONS: • PSA is a better predictor of future PCa than PSA-V, PSA-DT, or PSA-PC. • Adding PSA-V, PSA-DT, or PSA-PC to PSA does not result in clinically relevant improvements in the ability to predict future PCa.

Full Text

Duke Authors

Cited Authors

  • Inman, BA; Zhang, J; Shah, ND; Denton, BT

Published Date

  • August 2012

Published In

Volume / Issue

  • 110 / 3

Start / End Page

  • 375 - 381

PubMed ID

  • 22313933

Pubmed Central ID

  • 22313933

Electronic International Standard Serial Number (EISSN)

  • 1464-410X

Digital Object Identifier (DOI)

  • 10.1111/j.1464-410X.2011.10925.x


  • eng

Conference Location

  • England