1. A 4Kscore Cut-off of 7.5% for Prostate Biopsy Decisions Provides High Sensitivity and Negative Predictive Value for Significant Prostate Cancer.
- Author
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Bhattu, Amit S., Zappala, Stephen M., Parekh, Dipen J., and Punnen, Sanoj
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PROSTATE biopsy , *PROSTATE cancer , *PROSTATE-specific antigen , *OLDER men , *REFERENCE values , *PREDICTIVE tests , *CLINICAL trials , *BIOPSY , *AGE distribution , *PROSTATE , *EARLY detection of cancer , *BLOOD coagulation factors , *PROSTATE tumors , *TUMOR grading , *DIGITAL rectal examination - Abstract
Objective: To evaluate the 4Kscore test's low risk cut-off of 7.5% as the indication to proceed with a prostate biopsy by combining data from 2 independent prospective multicentre trials in the United States which have validated the 4Kscore test as a continuous score to predict clinically significant prostate cancer.Materials and Methods: We analyzed the data from 2 prospective multicenter trials in the United states to determine the number of men who could safely avoid a prostate biopsy and the presence of clinically significant cancers detected, at a 4Kscore cut-off of 7.5%. We evaluated this in the entire cohort, and 3 subgroups of men aged 45-75 years with a total prostate specific antigen between 3.0 and 10.0 ng/mL, African American, and non-African American men.Results: The analysis included 1378 patients. The combination analysis at a 7.5% threshold to decide upon a prostate biopsy, was associated with a 32% biopsy reduction. A total of 21 men (4.8%) with a low risk 4Kscore had International society of Urological Pathology, prostate cancer Grade group (GG) 2 or 3 cancer, leading to a sensitivity of 94% for detecting GG ≥2 cancer, and a negative predictive value of 95%. There were no GG ≥4 cancers with a low risk 4Kscore. Analyses in various subgroups afforded similar results.Conclusion: A 4Kscore test cut-off of 7.5% allowed a significant biopsy reduction, while maintaining high sensitivity and NPV for detecting and ruling out aggressive prostate cancer. [ABSTRACT FROM AUTHOR]- Published
- 2021
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