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The role of the prostate cancer gene 3 urine test in addition to serum prostate-specific antigen level in prostate cancer screening among breast cancer, early-onset gene mutation carriers
- Source :
- Urologic Oncology-Seminars and Original Investigations, 33(5), 202e19-202e28. Elsevier Inc., Urologic Oncology-Seminars and Original Investigations, 33, 202.e19-28, Urologic Oncology-Seminars and Original Investigations, 33, 5, pp. 202.e19-28
- Publication Year :
- 2015
- Publisher :
- Elsevier BV, 2015.
-
Abstract
- Contains fulltext : 154257.pdf (Publisher’s version ) (Open Access) OBJECTIVE: To evaluate the additive value of the prostate cancer gene 3 (PCA3) urine test to serum prostate-specific antigen (PSA) in prostate cancer (PC) screening among breast cancer, early-onset gene (BRCA) mutation carriers. This study was performed among the Dutch participants of IMPACT, a large international study on the effectiveness of PSA screening among BRCA mutation carriers. MATERIALS AND METHODS: Urinary PCA3 was measured in 191 BRCA1 mutation carriers, 75 BRCA2 mutation carriers, and 308 noncarriers. The physicians and participants were blinded for the results. Serum PSA level>/=3.0ng/ml was used to indicate prostate biopsies. PCA3 was evaluated (1) as an independent indicator for prostate biopsies and (2) as an indicator for prostate biopsies among men with an elevated PSA level. PC detected up to the 2-year screening was used as gold standard as end-of-study biopsies were not performed. RESULTS: Overall, 23 PCs were diagnosed, 20 of which were in men who had an elevated PSA level in the initial screening round. (1) PCA3, successfully determined in 552 participants, was elevated in 188 (cutoff>/=25; 34%) or 134 (cutoff>/=35; 24%) participants, including 2 of the 3 PCs missed by PSA. PCA3 would have added 157 (>/=25; 28%) or 109 (>/=35; 20%) biopsy sessions to screening with PSA only. (2) Elevated PCA3 as a requirement for biopsies in addition to PSA would have saved 37 (cutoff>/=25) or 43 (cutoff>/=35) of the 68 biopsy sessions, and 7 or 11 PCs would have been missed, respectively, including multiple high-risk PCs. So far, PCA3 performed best among BRCA2 mutation carriers, but the numbers are still small. Because PCA3 was not used to indicate prostate biopsies, its true diagnostic value cannot be calculated. CONCLUSIONS: The results do not provide evidence for PCA3 as a useful additional indicator of prostate biopsies in BRCA mutation carriers, as many participants had an elevated PCA3 in the absence of PC. This must be interpreted with caution because PCA3 was not used to indicate biopsies. Many participants diagnosed with PC had low PCA3, making it invalid as a restrictive marker for prostate biopsies in men with elevated PSA levels.
- Subjects :
- Oncology
PCA3
Male
medicine.medical_specialty
Urology
Gene mutation
prostate cancer gene 3
Breast Neoplasms, Male
03 medical and health sciences
Prostate cancer
PSA
0302 clinical medicine
Breast cancer
SDG 3 - Good Health and Well-being
Prostate
Internal medicine
Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15]
Biopsy
medicine
Biomarkers, Tumor
Humans
Early Detection of Cancer
030304 developmental biology
Aged
Gynecology
marker
0303 health sciences
medicine.diagnostic_test
business.industry
BRCA mutation
Prostatic Neoplasms
Middle Aged
Prostate-Specific Antigen
medicine.disease
BRCA2
3. Good health
medicine.anatomical_structure
Prostate cancer screening
Urological cancers Radboud Institute for Health Sciences [Radboudumc 15]
030220 oncology & carcinogenesis
Mutation
diagnostic value
business
Subjects
Details
- ISSN :
- 10781439
- Volume :
- 33
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Urologic Oncology: Seminars and Original Investigations
- Accession number :
- edsair.doi.dedup.....726fb51518c1323457bfa8d263a39693
- Full Text :
- https://doi.org/10.1016/j.urolonc.2015.01.018