Prostate cancer and the PCP: the screening dilemma

Rosenberg, Matt T.; Spring, Alexia; Crawford, E. David

doi:10.1111/ijcp.12745

Cited by 3 publications

(3 citation statements)

References 35 publications

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“…Although most of the previous 4Kscore clinical studies had access to the DRE information, and incorporated DRE in the model, several studies utilised the model without DRE information, and the model performance was also excellent . A DRE may not be routinely performed by the primary care physician during prostate screening and in this large group of men a 4Kscore may not be determined because of missing DRE information. An accurate blood test that does not require a DRE would potentially encourage further evaluation for aggressive prostate cancer.…”

Section: Introductionmentioning

confidence: 99%

The 4Kscore blood test accurately identifies men with aggressive prostate cancer prior to prostate biopsy with or without DRE information

Zappala

Dong²,

Linder³

et al. 2017

Int J Clin Pract

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Summary Introduction The 4Kscore Test is a prebiopsy blood test that incorporates four prostate protein biomarkers along with patient clinical information to determine a man's risk for high‐grade, aggressive (Gleason ≥7) prostate cancer. However, some men likely to benefit from the test may be seen in primary care settings where the digital rectal examination (DRE) information is not always obtained. In this study, we assessed the clinical validity of the 4Kscore Test when the DRE information was not included in the algorithm. Methods The Prospective 4Kscore Validation Study enrolled 1012 men scheduled for prostate biopsy across 26 urology practices in the United States. The 4Kscore was calculated for each patient with and without DRE information. The primary outcome was Gleason ≥7 prostate cancer on prostate biopsy. The contribution of DRE to the predictive accuracy of the test was evaluated by area under the receiver operating curve (AUC‐ROC), risk calibration and clinical consequences. Results High‐grade, aggressive prostate cancer was found in 231 (23%) of the 1012 patients. Both versions of the 4Kscore Test, with and without DRE, showed excellent discrimination (AUC=0.821 with DRE and AUC=0.818 without DRE input) and excellent calibration. No clinically significant difference was found between the two versions of the 4Kscore. Conclusions The 4Kscore Test algorithm, whether DRE findings are available or not, performs well in predicting a man's risk of high‐grade, aggressive prostate cancer. Patients who are suspected of having aggressive prostate cancer can safely have their risk better defined by 4Kscore even if a DRE has not been performed recently.

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Section: Introductionmentioning

confidence: 99%

The 4Kscore blood test accurately identifies men with aggressive prostate cancer prior to prostate biopsy with or without DRE information

Zappala

Dong²,

Linder³

et al. 2017

Int J Clin Pract

View full text Add to dashboard Cite

show abstract

“…A further paper outlining the role of the primary care physician in prostate cancer by Rosenberg et al. also advocates this threshold . Some would be apprehensive that lowering the threshold to this level would diagnose more clinically insignificant cancers.…”

Section: What Are the Reference Values For Psa?mentioning

confidence: 99%

Clarifying the PSA grey zone: The management of patients with a borderline PSA

et al. 2016

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“…Patients win, insurance wins, the doctor wins (because we did the right thing). Crawford and I have published an algorithm on the use of biomarkers in this journal and elsewhere and we are very pleased that more and more is showing up in the literature regarding the utility of clinical pathways in identifying the correct patient …”

mentioning

confidence: 97%

Make the DRE great again

Rosenberg

2017

Int J Clin Pract

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Prostate cancer and the PCP: the screening dilemma

Cited by 3 publications

References 35 publications

The 4Kscore blood test accurately identifies men with aggressive prostate cancer prior to prostate biopsy with or without DRE information

The 4Kscore blood test accurately identifies men with aggressive prostate cancer prior to prostate biopsy with or without DRE information

Clarifying the PSA grey zone: The management of patients with a borderline PSA

Make the DRE great again

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