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World Journal of Urology
Published in: World Journal of Urology 5/2008

Open Access 01-10-2008 | Topic Paper

Algorithms, nomograms and the detection of indolent prostate cancer

Author: Monique J. Roobol

Published in: World Journal of Urology | Issue 5/2008

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Abstract

Purpose

Prostate cancer is the most commonly diagnosed cancer in men. However, only about 12% of the men diagnosed with prostate cancer will die of their disease.

Result

The serum PSA test can detect prostate cancers early, but using a PSA based cut-off indication for prostate biopsy results in unnecessary testing in app. 75–80% of the men and perhaps even more important the serum PSA test cannot tell how aggressive the cancer is. To decrease unnecessary testing different test results are often combined, converted into a probability and displayed graphically. There are more than 40 of these so called nomograms in the case of prostate cancer. These nomograms can be divided into two categories, namely those that predict biopsy outcome using results from serum determination(s) or non-invasive tests such as the DRE and TRUS. The second category represents those nomograms that predict tumor characteristics and prognosis using information coming from pathology review.

Conclusion

The ultimate nomogram able to predict tumor characteristics and progression purely based on non-invasive testing will for a large part put an end to the negative side effects and uncertainties that coincide with the early detection of prostate cancer, if it will ever be made.
Literature
1.
Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ (2007) Cancer statistics,2007. CA Cancer J Clin 57(1):43–66PubMedCrossRef
2.
Adami HO, Baron JA, Rothman KJ (1994) Ethics of a prostate cancer screening trial. Lancet 343(8903):958–960PubMedCrossRef
3.
4.
5.
6.
Oottamasathien S, Crawford ED (2003) Should routine screening for prostate-specific antigen be recommended? Arch Intern Med 163(6):661–662PubMedCrossRef
7.
Hoffman RM (2003) An argument against routine prostate cancer screening. Arch Intern Med 163(6):663–665 discussion 665–6PubMedCrossRef
8.
Frankel S, Smith GD, Donovan J, Neal D (2003) Screening for prostate cancer. Lancet 361(9363):1122–1128PubMedCrossRef
9.
Wilson SS, Crawford ED (2004) Screening for prostate cancer. Clin Prostate Cancer 3(1):21–25PubMed
10.
Brawley OW (2004) Prostate cancer screening: Clinical applications and challenges. Urol Oncol 22(4):353–357PubMed
11.
Hoffman RM (2006) Viewpoint: limiting prostate cancer screening. Ann Intern Med 144(6):438–440PubMed
12.
Catalona WJ, Loeb S, Han M (2006) Viewpoint: expanding prostate cancer screening. Ann Intern Med 144(6):441–443PubMed
13.
Smith RA, Cokkinides V, Eyre HJ (2006.) American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin. 56:11–25,2004 54(1):41–52
14.
15.
American Urological Association (2000) Prostate-specific antigen (PSA) best practice policy. Oncology 14:277–278
16.
17.
18.
Albertsen PC (2005) What is the value of screening for prostate cancer in the US? Nat Clin Pract Oncol 2(11):536–537PubMedCrossRef
19.
De Antoni EP (1997) Eight years of “Prostate Cancer Awareness Week”: lessons in screening and early detection. Prostate Cancer Education Council. Cancer 80(9):1845–1851CrossRef
20.
Crawford ED (1997) Prostate Cancer Awareness Week: September 22 to 28, 1997. CA Cancer J Clin 47(5):288–296PubMedCrossRef
21.
Labrie F, Candas B, Cusan L, Gomez JL, Bélanger A, Brousseau G, Chevrette E, Lévesque J (2004) Screening decreases prostate cancer mortality: 11-year follow-up of the 1988 Quebec prospective randomized controlled trial. Prostate 59(3):311–318PubMedCrossRef
22.
Horniger W, Reissigl A, Rogatsch H, Volgger H, Studen M, Klocker H, Bartsch G (2000) Prostate cancer screening in the Tyrol, Austria: experience and results. Eur J Cancer 36(10):1322–1335CrossRef
23.
Roobol MJ, Schröder FH (guest editors). European Randomized Study of Screening for Prostate Cancer: rationale, structure and preliminary results 1994–2003. BJU Int. 2003 Dec;92 Suppl 2:1–122
24.
Prorok PC, Andriole GL, Bresalier RS, Buys SS, Chia D, Crawford ED, Fogel R,Gelmann EP, Gilbert F, Hasson MA, Hayes RB, Johnson CC, Mandel JS, Oberman A, O’Brien B, Oken MM, Rafla S, Reding D, Rutt W, Weissfeld JL, Yokochi L, Gohagan JK; Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial Project Team. Design of the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Control Clin Trials 2000 Dec;21(6 Suppl):273S–309S
25.
Dall’era MA, Cooperberg MR, Chan JM, Davies BJ, Albertsen PC, Klotz LH, Warlick CA, Holmberg L, Bailey DE Jr, Wallace ME, Kantoff PW, Carroll PR. Active surveillance for early-stage prostate cancer: review of the current literature. Cancer. 2008 Feb 27; [Epub ahead of print]
26.
Klotz L (2008) Low-risk prostate cancer can and should often be managed with active surveillance and selective delayed intervention. Nat Clin Pract Urol.5(1):2–3. Epub 2007 Nov 27. No abstract available
27.
Dall’era MA, Konety BR (2008) Active surveillance for low-risk prostate cancer: selection of patients and predictors of progression. Nat Clin Pract Urol
28.
29.
Roemeling S, Roobol MJ, Otto SJ, Habbema DF, Gosselaar C, Lous JJ, Cuzick J, Schröder FH (2007) Feasibility study of adjustment for contamination and non-compliance in a prostate cancer screening trial. Prostate 67(10):1053–1060PubMedCrossRef
30.
Otto SJ, van der Cruijsen IW, Liem MK, Korfage IJ, Lous JJ, Schröder FH, de Koning HJ (2003) Effective PSA contamination in the Rotterdam section of the European Randomized Study of Screening for Prostate Cancer. Int J Cancer 105(3):394–399PubMedCrossRef
31.
Farwell WR, Linder JA, Jha AK (2007) Trends in prostate-specific antigen testing from 1995 through 2004. Arch Intern Med 167(22):2497–2502PubMedCrossRef
32.
Jønler M, Eddy B, Poulsen J (2005) Prostate-specific antigen testing in general practice: a survey among 325 general practitioners in Denmark. Scand J Urol Nephrol 39(3):214–218PubMedCrossRef
33.
Kerfoot BP, Holmberg EF, Lawler EV, Krupat E, Conlin PR (2007) Practitioner-level determinants of inappropriate prostate-specific antigen screening. Arch Intern Med 167(13):1367–1372PubMedCrossRef
34.
Chapple A, Ziebland S, Hewitson P, McPherson A (2008) Why men in the United Kingdom still want the prostate specific antigen test. Qual Health Res 18(1):56–64PubMedCrossRef
35.
Guerra CE, Jacobs SE, Holmes JH, Shea JA (2007) Are physicians discussing prostate cancer screening with their patients and why or why not? A pilot study. J Gen Intern Med 22(7):901–907PubMedCrossRef
36.
O’Dell KJ, Volk RJ, Cass AR, Spann SJ (1999) Screening for prostate cancer with the prostate-specific antigen test: are patients making informed decisions? J Fam Pract 48(9):682–688PubMed
37.
Gattellari M, Ward JE (2005) Men’s reactions to disclosed and undisclosed opportunistic PSA screening for prostate cancer. Med J Aust 182(8):386–389PubMed
38.
Roobol MJ, Roobol DW, Schröder FH (2005) Is additional testing necessary in men with prostate-specific antigen levels of 1.0 ng/mL or less in a population-based screening setting? (ERSPC, section Rotterdam). Urology 65(2):343–346PubMedCrossRef
39.
Aus G, Damber JE, Khatami A, Lilja H, Stranne J, Hugosson J (2005) Individualized screening interval for prostate cancer based on prostate-specific antigen level: results of a prospective, randomized, population-based study. Arch Intern Med 165(16):1857–1861PubMedCrossRef
40.
Kobayashi T, Goto R, Ito K, Mitsumori K (2007) Prostate cancer screening strategies with re-screening interval determined by individual baseline prostate-specific antigen values are cost-effective. Eur J Surg Oncol 33(6):783–789PubMed
41.
Thompson IM, Ankerst DP, Chi C, Lucia MS, Goodman PJ, Crowley JJ, Parnes HL, Coltman CA Jr (2005) Operating characteristics of prostate-specific antigen in men with an initial PSA level of 30 ng/ml or lower. JAMA 294(1):66–70PubMedCrossRef
42.
Schröder FH, Bangma CH, Roobol MJ (2008) Is It Necessary to Detect All Prostate Cancers in Men with Serum PSA Levels <3.0 ng/ml? A Comparison of Biopsy Results of PCPT and Outcome-Related Information from ERSPC. Eur Urol. Jan 28; [Epub ahead of print]
43.
Welch HG, Schwartz LM, Woloshin S (2005) Prostate-specific antigen levels in the United States: implications of various definitions for abnormal. J Natl Cancer Inst 97(15):1132–1137PubMed
44.
Roobol MJ, Grenabo A, Schröder FH, Hugosson J (2007) Interval cancers in prostate cancer screening: comparing 2- and 4- year screening intervals in the European Randomized Study of Screening for Prostate Cancer, Gothenburg and Rotterdam. J Natl Cancer Inst 99(17):1296–1303PubMedCrossRef
45.
Eastham JA, May R, Robertson JL, Sartor O, Kattan MW (1999) Development of a nomogram that predicts the probability of a positive prostate biopsy in men with an abnormal digital rectal examination and a prostate-specific antigen between 0 and 4 ng/mL. Urology 54(4):709–713PubMedCrossRef
46.
Garzotto M, Hudson RG, Peters L, Hsieh YC, Barrera E, Mori M, Beer TM, Klein T (2003) Predictive modeling for the presence of prostate carcinoma using clinical, laboratory, and ultrasound parameters in patients with prostate specific antigen levels &lt; or = 10 ng/mL. Cancer 98(7):1417–1422PubMedCrossRef
47.
Karakiewicz PI, Benayoun S, Kattan MW, Perrotte P, Valiquette L, Scardino PT, Cagiannos I, Heinzer H, Tanguay S, Aprikian AG, Huland H, Graefen M (2005) Development and validation of a nomogram predicting the outcome of prostate biopsy based on patient age, digital rectal examination and serum prostate specific antigen. J Urol 173(6):1930–1934PubMedCrossRef
48.
Chun FK, Briganti A, Graefen M, Montorsi F, Porter C, Scattoni V, Gallina A, Walz J, Haese A, Steuber T, Erbersdobler A, Schlomm T, Ahyai SA, Currlin E, Valiquette L, Heinzer H, Rigatti P, Huland H, Karakiewicz PI (2007) Development and external validation of an extended 10-core biopsy nomogram. Eur Urol 52(2):436–444PubMedCrossRef
49.
Roobol MJ, Schröder FH, Kranse R (2006) ERSPC, Rotterdam A comparison of first and repeat (four years later) prostate cancer screening in a randomized cohort of a symptomatic men aged 55–75 years using a biopsy indication of 3.0 ng/ml (results of ERSPC, Rotterdam). Prostate 66(6):604–612PubMedCrossRef
50.
Deras IL, Aubin SM, Blase A, Day JR, Koo S, Partin AW, Ellis WJ, Marks LS, Fradet Y, Rittenhouse H, Groskopf J. (2008) PCA3: A Molecular Urine Assay for Predicting Prostate Biopsy Outcome. J Urol. [Epub ahead of print]
51.
Andriole GL, Levin DL, Crawford ED, Gelmann EP, Pinsky PF, Chia D, Kramer BS, Reding D, Church TR, Grubb RL, Izmirlian G, Ragard LR, Clapp JD, Prorok PC, Gohagan JK (2005) PLCO Project Team. Prostate Cancer Screening in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial: findings from the initial screening round of a randomized trial. J Natl Cancer Inst 97(6):433–438PubMedCrossRef
52.
Roobol MJ (2006) The use of nomograms in the detection of prostate cancer. Prostate 66(12):1266–1267PubMedCrossRef
53.
Makarov DV, Trock BJ, Humphreys EB, Mangold LA, Walsh PC, Epstein JI, Partin AW (2007) Updated nomogram to predict pathologic stage of prostate cancer given prostate-specific antigen level, clinical stage, and biopsy Gleason score (Partin tables) based on cases from 2000 to 2005. Urology 69(6):1095–1101PubMedCrossRef
54.
Kattan MW, Eastham JA, Stapleton AM, Wheeler TM, Scardino PT (1998) A preoperative nomogram for disease recurrence following radical prostatectomy for prostate cancer. J Natl Cancer Inst 90(10):766–771PubMedCrossRef
55.
Kattan MW, Zelefsky MJ, Kupelian PA, Scardino PT, Fuks Z, Leibel SA (2000) Pretreatment nomogram for predicting the outcome of three-dimensional conformal radiotherapy in prostate cancer. J Clin Oncol 18(19):3352–3359PubMed
56.
Kattan MW, Potters L, Blasko JC, Beyer DC, Fearn P, Cavanagh W, Leibel S, Scardino PT (2001) Pretreatment nomogram for predicting freedom from recurrence after permanent prostate brachytherapy in prostate cancer. Urology 58(3):393–399PubMedCrossRef
57.
Albertsen PC, Hanley JA, Fine J (2005) 20-year outcomes following conservative management of clinically localized prostate cancer. JAMA 293(17):2095–2101PubMedCrossRef
58.
Kattan MW, Eastham JA, Wheeler TM, Maru N, Scardino PT, Erbersdobler A, Graefen M, Huland H, Koh H, Shariat SF, Slawin KM, Ohori M (2003) Counseling men with prostate cancer: a nomogram for predicting the presence of small, moderately differentiated, confined tumors. J Urol 170(5):1792–1797PubMedCrossRef
59.
Steyerberg EW, Roobol MJ, Kattan MW, van der Kwast TH, de Koning HJ, Schröder FH (2007) Prediction of indolent prostate cancer: validation and updating of a prognostic nomogram. J Urol 177(1):107–112 discussion 112.PubMedCrossRef
60.
Roemeling S, Roobol MJ, Kattan MW, van der Kwast TH, Steyerberg EW, Schröder FH (2007) Nomogram use for the prediction of indolent prostate cancer: impact on screen-detected populations. Cancer 110(10):2218–2221PubMedCrossRef
61.
Bratt O (2006) Watching the face of Janus–active surveillance as a strategy to reduce overtreatment for localised prostate cancer. Eur Urol 50(3):410–412PubMedCrossRef
62.
van den Bergh RC, Roemeling S, Roobol MJ, Roobol W, Schröder FH, Bangma CH (2007) Prospective validation of active surveillance in prostate cancer: the PRIAS study. Eur Urol 52(6):1560–1563PubMedCrossRef
63.
Klotz L (2007) Active surveillance for favorable risk prostate cancer: rationale, risks, and results. Urol Oncol 25(6):505–509 ReviewPubMed
64.
Hardie C, Parker C, Norman A, Eeles R, Horwich A, Huddart R, Dearnaley D (2005) Early outcomes of active surveillance for localized prostate cancer. BJU Int 95(7):956–960PubMedCrossRef
65.
Roobol MJ, Wolters T, van den Bergh RCN, Schröder FH (2008) PSA based screening for prostate cancer modified by probability cut-off levels (ERSPC Rotterdam). ASCO poster # A2, San Francisco.
66.
67.
Roobol MJ, Zappa M, Määttänen L, Ciatto S (2007) The value of different screening tests in predicting prostate biopsy outcome in screening for prostate cancer data from a multicenter study (ERSPC). Prostate 67(4):439–446PubMedCrossRef
68.
Parekh DJ, Ankerst DP, Higgins BA, Hernandez J, Canby-Hagino E, Brand T, Troyer DA, Leach RJ, Thompson IM (2006) External validation of the Prostate Cancer Prevention Trial risk calculator in a screened population. Urology 68(6):1152–1155PubMedCrossRef
Metadata
Title
Algorithms, nomograms and the detection of indolent prostate cancer
Author
Monique J. Roobol
Publication date
01-10-2008
Publisher
Springer-Verlag
Published in
World Journal of Urology / Issue 5/2008
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-008-0278-8

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