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

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked FilesBACKGROUND: 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.Cancer Research UK Ronald and Rita McAulay Foundation NIHR Oxford Biomedical Research Centre Program Cancer Council Tasmania Cancer Australia Prostate Cancer Foundation of Australia Cancer Council of Victoria Cancer Council of South Australia Victorian Cancer Agency Clinical Trial Capacity Cancer Australia & Prostate Cancer Foundation of Australia Association of International Cancer Research Basser Center for BRCA National Cancer Institute Sidney Kimmel Center for Prostate and Urologic Cancers Prostate Cancer Foundation National Institute for Health Research (NIHR) Oxford Biomedical Research Centre Program in UK Swedish Cancer Society Swedish Research Council (VR-MH) Slovenian Research Agency MINIECO Asociacion Espanola Contra el Cancer (AECC) Instituto de Salud Carlos III (organismo adscrito al Ministerio de Economia y Competitividad) Fondo Europeo de Desarrollo Regional (FEDER), una manera de hacer Europa Fondo Europeo de Desarrollo Regional (FEDER), una manera de hacer Europa (CIBERONC) Institut Catala de la Salut Autonomous Government of Catalonia Autonomous Government of Catalonia (PERIS Project MedPerCan