OBJECTIVE: To describe the results of 3 rounds of diagnostic testing and linkage to the Dutch Cancer Registry for men with an initial prostate cancer antigen 3 (PCA3) score ≥100.
METHODS: Within an earlier reported comparative study of PCA3 vs prostate-specific antigen in a prescreened population, 90 men with a PCA3 score ≥100 were identified and underwent biopsy, 28 prostate cancers (PCs) were found, 62 men remained at risk of a diagnosis of PC. All men were offered repeat testing; 6 PCs were found in 20 men at rebiopsy. Men with at least 1 negative biopsy (n = 56) were invited to undergo magnetic resonance imaging (MRI) studies and MRI-guided biopsies if indicated. Linkage to the Dutch Cancer Registry after 2.8 years of follow-up was performed for men with negative biopsies.
RESULTS: Of the 56 men at risk, 28 agreed to participate in further testing. They were offered MRI studies; only 7 men agreed, and in 2, suspicious lesions were found and biopsies carried out. Only 1 PC was diagnosed and classified as T1c, Gleason 3 + 3 = 6. The overall findings of 3 rounds of testing and of linkage to the cancer registry show that eventually 35 PCs were detected in 90 men with PCA3 scores ≥100 (positive predictive value 38.9%).
CONCLUSION: Finding no PC despite extended diagnostic efforts in many men with initial PCA3 scores ≥100 is unexpected and might be clinically relevant.
Written by:
Schröder FH, Venderbos LD, van den Bergh RC, Hessels D, van Leenders GJ, van Leeuwen PJ, Wolters T, Barentsz JO, Roobol MJ. Are you the author?
Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Reference: Urology. 2014 Mar;83(3):613-6.
doi: 10.1016/j.urology.2013.12.005
PubMed Abstract
PMID: 24581524
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