TY  - EJOU
AU  - Stanton, Whitney N. 
AU  - Crawford, E. David 
AU  - Arangua, Paul B. 
AU  - Rosa, Francisco G. La 
AU  - Bokhoven, Adrie van 
AU  - Lucia, M. Scott 
AU  - Poage, Wendy L. 
AU  - Partin, Alan 
AU  - Maroni, Paul 
AU  - Werahera, Priya N. 

TI  - Assessment of high-grade prostate cancer risk using prostate cancer biomarkers
T2  - Canadian Journal of Urology

PY  - 2020
VL  - 27
IS  - 1
SN  - 1488-5581

AB  - <b>Introduction:</b> To identify patients at risk of high-grade prostate cancer using prostate cancer biomarkers.<br/>
<b>Materials and methods:</b> A total of 601 men were screened for prostate cancer in 2012, 2015, and 2016 using prostate cancer biomarkers: prostate health index (phi), 4KScore, and SelectMDx. The first two are blood tests that incorporate several PSA isoforms; SelectMDx measures mRNA levels of homeobox C6 and distal-less homeobox 1 in post-digital rectal examination urine samples. The performance of each biomarker was evaluated using cut-off values based on published literature. Gleason Grade Group (GG) ≥ 2 is considered as high-grade prostate cancer.<br/>
<b>Results:</b> For patients with PSA < 1.5 ng/mL, none were at risk for GG ≥ 2 cancer based on SelectMDx > 0%, whereas 17.1% were at intermediate to high risk of finding GG ≥ 2 cancer with 4KScore ≥ 7.5%, and 3.5% were at risk of finding any prostate cancer with phi ≥ 36 at biopsy. For cut-offs revised for finding men at high risk for GG ≥ 2 cancer at biopsy, only one patient with PSA < 1.5 ng/mL would be at risk with 4KScore ≥ 20% and none with phi ≥ 52.7. For patients with PSA 1.5 to 3.99 ng/mL, 2%, 8%, and 1% were at high risk for finding GG ≥ 2 cancer at biopsy based on phi, 4KScore, and SelectMDx, respectively.<br/>
<b>Conclusions:</b> Men with PSA < 1.5 ng/mL are at very low risk of finding high-grade prostate cancer at biopsy. However, some men with PSA between 1.5 to 3.99 ng/mL may be at intermediate to high risk for high-grade prostate cancer. Thus, primary care physicians could run biomarker tests and refer those with positive biomarker results to a specialist for further evaluation.
KW  - prostate cancer
KW  -  screening
KW  -  biomarkers
KW  -  PSA
KW  -  phi
KW  -  4Kscore
KW  -  SelectMDx

DO  -