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Related Experiment Videos

Volume adjustment for intermediate prostate-specific antigen values in a screening population

C H Bangma1, D E Grobbee, F H Schröder

  • 1Department of Urology, Erasmus University and Academic Hospital, Rotterdam, The Netherlands.

European Journal of Cancer (Oxford, England : 1990)
|January 1, 1995
PubMed
Summary

This study found that volume-adjusted prostate-specific antigen (PSA) levels did not improve prostate cancer screening accuracy beyond standard PSA tests. Unadjusted PSA values were as effective as density and excess PSA measures in detecting prostate cancer.

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Area of Science:

  • Urology
  • Oncology
  • Medical Diagnostics

Background:

  • Prostate-specific antigen (PSA) is a key biomarker for prostate cancer screening.
  • Volume-adjusted PSA metrics, such as PSA density (PSAD) and PSA transit (PSAT), have been proposed to enhance diagnostic accuracy.
  • Evaluating the utility of these adjusted PSA values in screening populations is crucial.

Purpose of the Study:

  • To assess the effectiveness of volume-adjusted PSA levels compared to unadjusted PSA in screening for prostate cancer.
  • To determine if PSA density (PSAD), PSA transit (PSAT), and excess PSA values offer additional diagnostic benefit.
  • To analyze the discriminatory potential of different PSA metrics using ROC curves.

Main Methods:

  • A screening population of 812 men aged 55-77 with PSA < 10.0 ng/ml underwent digital rectal examination (DRE) and transrectal ultrasonography (TRUS).

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  • Four methods of prostate volumetry were used to calculate volume-adjusted PSA levels: PSAD, PSAT, and excess PSA.
  • Receiver Operating Characteristic (ROC) curve analysis was employed to evaluate the discriminatory power of each method.

    • Main Results:

    • Seventeen prostate carcinomas were detected in the screening population.
    • Significant differences were observed between benign and malignant groups for age, PSA, PSAD, PSAT, and excess PSA.
    • The highest discriminatory potential (Area Under Curve = 0.90) was achieved with prolate spheroid determined excess PSA, compared to PSA alone (AUC = 0.86).

    Conclusions:

    • Volume-adjusted PSA values, including PSAD and PSAT, did not demonstrate additional benefit over unadjusted PSA in this prostate cancer screening study.
    • Unadjusted PSA levels showed comparable discriminatory potential to volume-adjusted metrics in this specific cohort.
    • Further research may be needed to clarify the role of advanced PSA calculations in prostate cancer screening protocols.