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• W2121392023 abstract "No AccessJournal of UrologyClinical Urology: Original Article1 Mar 1997Prospective Evaluation of Prostate Specific Antigen and Prostate Specific Antigen Density in the Detection of Carcinoma of the Prostate: Ethnic Variations Joseph C. Presti, Regina Hovey, Vivek Bhargava, Peter R. Carroll, and Katsuto Shinohara Joseph C. PrestiJoseph C. Presti More articles by this author , Regina HoveyRegina Hovey More articles by this author , Vivek BhargavaVivek Bhargava More articles by this author , Peter R. CarrollPeter R. Carroll More articles by this author , and Katsuto ShinoharaKatsuto Shinohara More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65080-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated prospectively the ethnic variations in prostate specific antigen (PSA) and prostate specific antigen density in the detection of carcinoma of the prostate. Materials and Methods: A total of 297 consecutive patients with an elevated serum PSA and/or abnormal digital rectal examination underwent transrectal ultrasound with lesion directed and systematic biopsy (6 if the prostatic volume was 50 cc or less and 12 if it was greater than 50 cc). Receiver operating characteristic curves, predictive values and likelihood ratios were calculated for PSA and PSA density for white and black patients. Ethnic analysis was performed for the entire group, patients with a normal digital rectal examination, and those with a normal digital rectal examination and PSA of 4 to 10 ng./ml. Results: Of the 297 patients 131 (44%) had cancer, including 48 of 97 black (50%) and 83 of 200 white (42%) patients. Median PSA, PSA density and prostate size did not differ between the positive or negative biopsy groups, or between the ethnic groups in any of the analyses. If all digital rectal examinations were considered PSA density was superior to PSA by receiver operating characteristic analysis for cancer detection in both ethnic groups when all values or PSA of 4 to 10 ng./ml. were considered. However, the significance was lost if only patients with a normal digital rectal examination were considered. In general, predictive values were greater in black patients. Likelihood ratios for a negative test result in black patients demonstrated significant changes in the post-test probability if a PSA density cutoff of 0.1 was used to determine the need for biopsy. Many unnecessary biopsies could be avoided and few cancers would be missed. Conclusions: A PSA density cutoff of 0.1 may be warranted in determining the need for prostate biopsy in black men with a normal digital rectal examination. References 1 : High grade prostatic intraepithelial neoplasia (HGPIN) and prostatic adenocarcinoma between the ages of 20-69. An autopsy study of 249 cases. In Vivo1994; 8: 439. Google Scholar 2 : Epidemiology of high grade prostatic intraepithelial neoplasia. Path. Res. Pract.1995; 191: 838. Google Scholar 3 : Prostate-specific antigen values at the time of prostate cancer diagnosis in African-American men. J.A.M.A.1995; 274: 1277. Crossref, Medline, Google Scholar 4 : Age-specific reference ranges for serum prostate-specific antigen in Black men. New Engl. J. Med.1996; 335: 304. Google Scholar 5 : Users' guides to the medical literature III. How to use an article about a diagnostic test B. What are the results and will they help me in caring for my patients? J.A.M.A.1994; 271: 703. Google Scholar 6 : Comparison of prostate specific antigen concentration versus prostate specific antigen density in the early detection of prostate cancer: receiver operating characteristic curves. J. Urol.1994; 152: 2031. Link, Google Scholar 7 : Prospective evaluation of prostate-specific antigen density and systematic biopsies for early detection of prostatic carcinoma. Urology1994; 43: 44. Google Scholar 8 : The lack of predictive value of prostate specific antigen density in the detection of prostate cancer in patients with normal rectal examinations and intermediate prostate specific antigen levels. J. Urol.1995; 154: 1070. Link, Google Scholar 9 : The inability of prostate specific antigen index to enhance the predictive value of prostate specific antigen in the diagnosis of prostatic carcinoma. J. Urol.1993; 150: 369. Link, Google Scholar 10 : Nomogram for Bayes theorem. Letter to the Editor. New Engl. J. Med.1975; 293: 257. Google Scholar Departments of Urology and Pathology, University of California School of Medicine, San Francisco Veterans Administration Medical Center, and University of California-San Francisco/Mount Zion Cancer Center, San Francisco, California© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKryvenko O, Epstein J and Cote R (2016) Do Black NonHispanic Men Produce Less Prostate Specific Antigen in Benign Prostate Tissue or Cancer Compared to White NonHispanic Men with Gleason Score 6 (Grade Group 1) Prostate Cancer?Journal of Urology, VOL. 196, NO. 6, (1659-1663), Online publication date: 1-Dec-2016.Kryvenko O, Balise R, Soodana Prakash N and Epstein J (2015) African-American Men with Gleason Score 3+3=6 Prostate Cancer Produce Less Prostate Specific Antigen than Caucasian Men: A Potential Impact on Active SurveillanceJournal of Urology, VOL. 195, NO. 2, (301-306), Online publication date: 1-Feb-2016.Elliott C, Shinghal R and Presti J (2008) Racial Variations in the Performance of Prostate Specific Antigen and Prostate Specific Antigen Density in the Era of Extended Prostate Biopsy SchemesJournal of Urology, VOL. 180, NO. 4, (1318-1324), Online publication date: 1-Oct-2008.LAM J, CHEUNG Y, BENSON M and GOLUBOFF E (2018) Comparison of the Predictive Accuracy of Serum Prostate Specific Antigen Levels and Prostate Specific Antigen Density in the Detection of Prostate Cancer in Hispanic-American and White MenJournal of Urology, VOL. 170, NO. 2, (451-456), Online publication date: 1-Aug-2003.ROBERTS R, BERGSTRALH E, PETERSON N, BOSTWICK D, LIEBER M and JACOBSEN S (2018) POSITIVE AND NEGATIVE BIOPSIES IN THE PRE-PROSTATE SPECIFIC ANTIGEN AND PROSTATE SPECIFIC ANTIGEN ERAS, 1980 TO 1997Journal of Urology, VOL. 163, NO. 5, (1471-1475), Online publication date: 1-May-2000.MOUL J, CONNELLY R, MOONEYHAN R, ZHANG W, SESTERHENN I, MOSTOFI F and McLEOD D (2018) RACIAL DIFFERENCES IN TUMOR VOLUME AND PROSTATE SPECIFIC ANTIGEN AMONG RADICAL PROSTATECTOMY PATIENTSJournal of Urology, VOL. 162, NO. 2, (394-397), Online publication date: 1-Aug-1999. (2018) REPLY BY AUTHORSJournal of Urology, VOL. 158, NO. 3, (864-864), Online publication date: 1-Sep-1997. Volume 157Issue 3March 1997Page: 907-912 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Joseph C. Presti More articles by this author Regina Hovey More articles by this author Vivek Bhargava More articles by this author Peter R. Carroll More articles by this author Katsuto Shinohara More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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