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New Way to Predict Prostate Cancer Risk

Personalized Risk Calculator May Help Identify Men at High Risk for Prostate Cancer

PSA and Prostate Cancer Risk continued...

In contrast, a man with a previous negative biopsy, no family history, and a large prostate could have a PSA of up to 4.0 before he would have a 5% risk of prostate cancer within four years.

"This is a very sensitive method of integrating other factors besides PSA into prostate cancer screening and detection," says Howard M. Sandler, MD, a prostate cancer specialist at Cedars-Sinai Medical Center in Los Angeles.

Sandler moderated a press briefing to discuss the findings, which are being presented later this week at the Genitourinary Cancers Symposium in Orlando, Fla. He's an official with the symposium.

Urine Test for Aggressive Prostate Cancers

Also at the meeting, researchers reported that they have developed a urine test that may be able to help identify prostate cancers that are most likely to grow and spread quickly.

The experimental test is known as the T2:ERG urine test. It detects the fusion of two genes that are found in about half of prostate cancers and have been associated with more aggressive disease.

"There is an unmet need for tests that can determine which patients need aggressive treatment such as surgery to remove the prostate and those that can be managed conservatively with close monitoring for signs of tumor growth," says Jack Groskopf, PhD, of Gen-Probe Incorporated, the developer of the urine test.

Widespread use of PSA blood testing has resulted in high rates of early prostate cancer detection. The PSA test is not useful, however, for predicting which men have aggressive disease, he says.

Furthermore, the PSA test is associated with a high rate of false positives and unnecessary biopsies, Groskopf says.

Low False-Positive Rate

The new study involved 556 men scheduled for prostate biopsy. The biopsies showed that 226 of the men (41%) had prostate cancer.

The new urine test gave false-positive results to 15% of men that did not have prostate cancer. The comparable figure for PSA testing is 73%, according to data cited in the study.

Moreover, the urine test results correlated with criteria currently used to identify aggressive cancer at the time of biopsy, such as tumor grade and the amount of cancer found in the biopsy tissue.

"It was able to distinguish between significant and indolent cancers," Groskopf tells WebMD.

Prostate cancer is diagnosed in more than 186,320 Americans and claims more than 28,000 lives each year.

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