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    Prostate-specific antigen velocity in a prospective prostate cancer screening study of men with genetic predisposition

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    Author
    Mikropoulos, C; Selkirk, CGH; Saya, S; Bancroft, E; Vertosick, E; Dadaev, T; Brendler, C; Page, E; Dias, A; Evans, DG; ...
    Date
    2018-01-23
    Source Title
    British Journal of Cancer
    Publisher
    NATURE PUBLISHING GROUP
    University of Melbourne Author/s
    Lindeman, Geoffrey; Murphy, Declan; Saya, Sibel; James, Paul
    Affiliation
    General Practice
    Surgery (St Vincent's)
    Medicine and Radiology
    Sir Peter MacCallum Department of Oncology
    Metadata
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    Document Type
    Journal Article
    Citations
    Mikropoulos, C., Selkirk, C. G. H., Saya, S., Bancroft, E., Vertosick, E., Dadaev, T., Brendler, C., Page, E., Dias, A., Evans, D. G., Rothwell, J., Maehle, L., Axcrona, K., Richardson, K., Eccles, D., Jensen, T., Osther, P. J., van Asperen, C. J., Vasen, H. ,... Eeles, R. A. (2018). Prostate-specific antigen velocity in a prospective prostate cancer screening study of men with genetic predisposition. BRITISH JOURNAL OF CANCER, 118 (2), pp.266-276. https://doi.org/10.1038/bjc.2017.429.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255954
    DOI
    10.1038/bjc.2017.429
    Abstract
    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. 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. 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. 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.

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