A new study entitled “Focusing PSA Testing on Detection of High-Risk Prostate Cancers by Incorporating Patient Preferences Into Decision Making” and published in the Journal of the American Medical Association, describes the updates and benefits of a calculator developed at the University of Texas Health Science Center, designed to help men and their doctors assess their risk of prostate cancer.
“The prostate cancer risk calculator has been updated using current risk factors and a better interface; the current version gives a more nuanced result that helps understand a man’s risk of prostate cancer,” Ian M. Thompson Jr., M.D., director of the Cancer Therapy & Research Center at the UT Health Science Center, who helped develop the risk calculator and co-authored the article said in a UT Health Science Center press release.
The free calculator is available at the Health Science Center website, is user friendly and can quickly provide numeric information about the potential risk for low-grade and high-grade prostate cancer.
High-grade high-risk cancers are the types of prostate cancer that require early detection, since action can immediately be taken to prolong and save a patient’s life.
This risk assessment tool was first developed in 2006, based on information from 5519 men in the Prostate Cancer Prevention Trial (PCPT), all of whom had undergone a prostate biopsy regardless of PSA level and in whom other risk variables (age, race/ethnicity, family history of prostate cancer, prior biopsy information, and rectal examination findings) were known.
The researchers used individual patient information to enable the calculator to predict 3 possible outcomes — negative biopsy result, low-grade cancer, or high-grade cancer.
“What is important are the three numbers. For doctors, it makes for a more challenging conversation with the patient. For the patient, it gives him better information so he can decide how he wants to move forward. On the other hand, in some men, a prostate biopsy will far more commonly find a low-grade cancer. These cancers have such a low risk that many men who take the time to fully understand the options, decide to simply monitor them. For many men who have been diagnosed with these low-risk cancers, they wish they’d known about that before they had a prostate biopsy; many, in retrospect wish they’d not had a biopsy in the first place. This new risk calculator helps them understand that risk in advance”, Dr. Thompson added in the press release.
As treatments and screenings evolve, the risk factors that affect the calculations also change. As a consequence, the team continued to validate and update the calculator since it first was developed.
“The new calculator should provide a more accurate prediction of the outcome that a man would expect on biopsy because it incorporates a substantially larger amount of patient data than the original calculator. It also uses an advanced statistical model to distinguish the prediction of low-grade and high-grade disease.” Donna Ankerst, Ph.D., research professor of urology at the Health Science Center and professor of mathematics at the Technical University in Munich, who helped develop the calculator said in the press release.
Furthermore, the new calculator also incorporates data from the San Antonio Center of Biomarkers Of Risk for Prostate Cancer (SABOR), a parallel study conducted by Dr. Thompson that resulted in a new calculator biomarker called percent-free PSA.
“Step by step, we are assembling the tools to help men work with their doctors to make better-informed decisions about their treatment. And, as steps go, this is a big one,” Dr. Thompson concluded.
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