Effect of Finasteride on the Sensitivity of PSA for Detecting Prostate Cancer
Background: In the Prostate Cancer Prevention Trial (PCPT), men receiving finasteride had a 24.8% lower risk of prostate cancer than men receiving placebo but a higher risk of high-grade cancer. We examined the impact of finasteride on the sensitivity and area under the receiver operating characteri...
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| creator | Thompson, Ian M. Chi, Chen Ankerst, Donna Pauler Goodman, Phyllis J. Tangen, Catherine M. Lippman, Scott M. Lucia, M. Scott Parnes, Howard L. Coltman, Charles A. |
| description | Background: In the Prostate Cancer Prevention Trial (PCPT), men receiving finasteride had a 24.8% lower risk of prostate cancer than men receiving placebo but a higher risk of high-grade cancer. We examined the impact of finasteride on the sensitivity and area under the receiver operating characteristic curve (AUC) of prostate-specific antigen (PSA) for detecting prostate cancer. Methods: We studied men in the placebo and finasteride groups of the PCPT who had a prostate biopsy and concurrent PSA tests during the 7-year study. We compared the placebo and finasteride groups for sensitivity and AUC of PSA for the detection of all prostate cancer, of Gleason grade 7 or higher prostate cancer, and of Gleason grade 8 or higher prostate cancer. All statistical tests were two-sided. Results: Of 5112 men in the placebo group, prostate cancer was detected in 1111. Gleason tumor grade was available for 1100 men, of whom 240 had grade 7 or higher and 55 had grade 8 or higher. Of 4579 men in the finasteride group, 695 had prostate cancer. Gleason grade was available for 686 men, of whom 264 had grade 7 or higher and 81 had grade 8 or higher. The AUC of PSA for all outcomes was greater for the finasteride group than the placebo group. For detecting prostate cancer versus no cancer, the AUCs were 0.757 and 0.681, respectively (P |
| doi_str_mv | 10.1093/jnci/djj307 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68754643</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>68754643</sourcerecordid><originalsourceid>FETCH-LOGICAL-c485t-c07bf4f0e5b1d86446b23f48f02e18f4f84327e42742a2036bb7a291c199fdae3</originalsourceid><addsrcrecordid>eNpd0M1LHDEYwOFQlLrannovoaAXmZqvSTJHWT9WsHRFBeklZDJv2kx3ZzTJFv3vzbJLBXPJIU9ekh9CXyj5TknDT_rBhZOu7zlRH9CECkkqRkm9gyaEMFVprcQe2k-pJ2U1THxEe1Q2lDFZT9CPc-_BZTx6fBEGmzLE0AEeB5z_AL6FIYUc_oX8shbz21Psx4jPIJc7YfiN53FM2WbAUzs4iJ_QrreLBJ-3-wG6vzi_m86q65-XV9PT68oJXefKEdV64QnULe20FEK2jHuhPWFAdTnRgjMFginBLCNctq2yrKGONo3vLPADdLSZ-xjHpxWkbJYhOVgs7ADjKhmpVS2k4AV-ewf7cRWH8jbDSiTGWU0KOt4gV36TInjzGMPSxhdDiVknNuvEZpO46K_bkat2Cd2b3TYt4HALbHJ24WNJE9Kb00wLoZriqo0Lpfrz_3Mb_xqpuKrN7OGXUbP5jdR6Zh74K1fvknk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>221023250</pqid></control><display><type>article</type><title>Effect of Finasteride on the Sensitivity of PSA for Detecting Prostate Cancer</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Thompson, Ian M. ; Chi, Chen ; Ankerst, Donna Pauler ; Goodman, Phyllis J. ; Tangen, Catherine M. ; Lippman, Scott M. ; Lucia, M. Scott ; Parnes, Howard L. ; Coltman, Charles A.</creator><creatorcontrib>Thompson, Ian M. ; Chi, Chen ; Ankerst, Donna Pauler ; Goodman, Phyllis J. ; Tangen, Catherine M. ; Lippman, Scott M. ; Lucia, M. Scott ; Parnes, Howard L. ; Coltman, Charles A.</creatorcontrib><description>Background: In the Prostate Cancer Prevention Trial (PCPT), men receiving finasteride had a 24.8% lower risk of prostate cancer than men receiving placebo but a higher risk of high-grade cancer. We examined the impact of finasteride on the sensitivity and area under the receiver operating characteristic curve (AUC) of prostate-specific antigen (PSA) for detecting prostate cancer. Methods: We studied men in the placebo and finasteride groups of the PCPT who had a prostate biopsy and concurrent PSA tests during the 7-year study. We compared the placebo and finasteride groups for sensitivity and AUC of PSA for the detection of all prostate cancer, of Gleason grade 7 or higher prostate cancer, and of Gleason grade 8 or higher prostate cancer. All statistical tests were two-sided. Results: Of 5112 men in the placebo group, prostate cancer was detected in 1111. Gleason tumor grade was available for 1100 men, of whom 240 had grade 7 or higher and 55 had grade 8 or higher. Of 4579 men in the finasteride group, 695 had prostate cancer. Gleason grade was available for 686 men, of whom 264 had grade 7 or higher and 81 had grade 8 or higher. The AUC of PSA for all outcomes was greater for the finasteride group than the placebo group. For detecting prostate cancer versus no cancer, the AUCs were 0.757 and 0.681, respectively (P<.001); for detecting Gleason grade ≥7 versus ≤6 or no cancer, the AUCs were 0.838 and 0.781, respectively (P = .003); and for detecting Gleason grade ≥8 versus ≤7 or no cancer, the AUCs were 0.886 and 0.824, respectively (P = .071). The sensitivity of PSA was higher for men in the finasteride group than in the placebo group at all PSA cutoffs matched by specificity. Conclusions: PSA had statistically significantly better sensitivity and AUC for detecting prostate cancer in the finasteride arm of the PCPT than in the placebo arm. This bias would be expected to contribute to greater detection of all grades of prostate cancer with finasteride.</description><identifier>ISSN: 0027-8874</identifier><identifier>EISSN: 1460-2105</identifier><identifier>DOI: 10.1093/jnci/djj307</identifier><identifier>PMID: 16912265</identifier><identifier>CODEN: JNCIEQ</identifier><language>eng</language><publisher>Cary, NC: Oxford University Press</publisher><subject>Aged ; Area Under Curve ; Biological and medical sciences ; Biopsy ; Clinical outcomes ; Diagnostic tests ; Disease prevention ; Drug therapy ; Enzyme Inhibitors - pharmacology ; Finasteride - pharmacology ; Humans ; Male ; Medical sciences ; Middle Aged ; Nephrology. Urinary tract diseases ; Predictive Value of Tests ; Prostate cancer ; Prostate-Specific Antigen - blood ; Prostatic Hyperplasia - diagnosis ; Prostatic Hyperplasia - immunology ; Prostatic Neoplasms - diagnosis ; Prostatic Neoplasms - immunology ; Prostatic Neoplasms - pathology ; Prostatitis - diagnosis ; Prostatitis - immunology ; Research Design ; ROC Curve ; Sensitivity and Specificity ; Tumors ; Tumors of the urinary system ; Urinary tract. Prostate gland ; Validation studies</subject><ispartof>JNCI : Journal of the National Cancer Institute, 2006-08, Vol.98 (16), p.1128-1133</ispartof><rights>2007 INIST-CNRS</rights><rights>Copyright Oxford University Press(England) Aug 16, 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c485t-c07bf4f0e5b1d86446b23f48f02e18f4f84327e42742a2036bb7a291c199fdae3</citedby><cites>FETCH-LOGICAL-c485t-c07bf4f0e5b1d86446b23f48f02e18f4f84327e42742a2036bb7a291c199fdae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18284479$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16912265$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thompson, Ian M.</creatorcontrib><creatorcontrib>Chi, Chen</creatorcontrib><creatorcontrib>Ankerst, Donna Pauler</creatorcontrib><creatorcontrib>Goodman, Phyllis J.</creatorcontrib><creatorcontrib>Tangen, Catherine M.</creatorcontrib><creatorcontrib>Lippman, Scott M.</creatorcontrib><creatorcontrib>Lucia, M. Scott</creatorcontrib><creatorcontrib>Parnes, Howard L.</creatorcontrib><creatorcontrib>Coltman, Charles A.</creatorcontrib><title>Effect of Finasteride on the Sensitivity of PSA for Detecting Prostate Cancer</title><title>JNCI : Journal of the National Cancer Institute</title><addtitle>JNCI J Natl Cancer Inst</addtitle><description>Background: In the Prostate Cancer Prevention Trial (PCPT), men receiving finasteride had a 24.8% lower risk of prostate cancer than men receiving placebo but a higher risk of high-grade cancer. We examined the impact of finasteride on the sensitivity and area under the receiver operating characteristic curve (AUC) of prostate-specific antigen (PSA) for detecting prostate cancer. Methods: We studied men in the placebo and finasteride groups of the PCPT who had a prostate biopsy and concurrent PSA tests during the 7-year study. We compared the placebo and finasteride groups for sensitivity and AUC of PSA for the detection of all prostate cancer, of Gleason grade 7 or higher prostate cancer, and of Gleason grade 8 or higher prostate cancer. All statistical tests were two-sided. Results: Of 5112 men in the placebo group, prostate cancer was detected in 1111. Gleason tumor grade was available for 1100 men, of whom 240 had grade 7 or higher and 55 had grade 8 or higher. Of 4579 men in the finasteride group, 695 had prostate cancer. Gleason grade was available for 686 men, of whom 264 had grade 7 or higher and 81 had grade 8 or higher. The AUC of PSA for all outcomes was greater for the finasteride group than the placebo group. For detecting prostate cancer versus no cancer, the AUCs were 0.757 and 0.681, respectively (P<.001); for detecting Gleason grade ≥7 versus ≤6 or no cancer, the AUCs were 0.838 and 0.781, respectively (P = .003); and for detecting Gleason grade ≥8 versus ≤7 or no cancer, the AUCs were 0.886 and 0.824, respectively (P = .071). The sensitivity of PSA was higher for men in the finasteride group than in the placebo group at all PSA cutoffs matched by specificity. Conclusions: PSA had statistically significantly better sensitivity and AUC for detecting prostate cancer in the finasteride arm of the PCPT than in the placebo arm. This bias would be expected to contribute to greater detection of all grades of prostate cancer with finasteride.</description><subject>Aged</subject><subject>Area Under Curve</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Clinical outcomes</subject><subject>Diagnostic tests</subject><subject>Disease prevention</subject><subject>Drug therapy</subject><subject>Enzyme Inhibitors - pharmacology</subject><subject>Finasteride - pharmacology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Predictive Value of Tests</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatic Hyperplasia - diagnosis</subject><subject>Prostatic Hyperplasia - immunology</subject><subject>Prostatic Neoplasms - diagnosis</subject><subject>Prostatic Neoplasms - immunology</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatitis - diagnosis</subject><subject>Prostatitis - immunology</subject><subject>Research Design</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Tumors</subject><subject>Tumors of the urinary system</subject><subject>Urinary tract. Prostate gland</subject><subject>Validation studies</subject><issn>0027-8874</issn><issn>1460-2105</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0M1LHDEYwOFQlLrannovoaAXmZqvSTJHWT9WsHRFBeklZDJv2kx3ZzTJFv3vzbJLBXPJIU9ekh9CXyj5TknDT_rBhZOu7zlRH9CECkkqRkm9gyaEMFVprcQe2k-pJ2U1THxEe1Q2lDFZT9CPc-_BZTx6fBEGmzLE0AEeB5z_AL6FIYUc_oX8shbz21Psx4jPIJc7YfiN53FM2WbAUzs4iJ_QrreLBJ-3-wG6vzi_m86q65-XV9PT68oJXefKEdV64QnULe20FEK2jHuhPWFAdTnRgjMFginBLCNctq2yrKGONo3vLPADdLSZ-xjHpxWkbJYhOVgs7ADjKhmpVS2k4AV-ewf7cRWH8jbDSiTGWU0KOt4gV36TInjzGMPSxhdDiVknNuvEZpO46K_bkat2Cd2b3TYt4HALbHJ24WNJE9Kb00wLoZriqo0Lpfrz_3Mb_xqpuKrN7OGXUbP5jdR6Zh74K1fvknk</recordid><startdate>20060816</startdate><enddate>20060816</enddate><creator>Thompson, Ian M.</creator><creator>Chi, Chen</creator><creator>Ankerst, Donna Pauler</creator><creator>Goodman, Phyllis J.</creator><creator>Tangen, Catherine M.</creator><creator>Lippman, Scott M.</creator><creator>Lucia, M. Scott</creator><creator>Parnes, Howard L.</creator><creator>Coltman, Charles A.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20060816</creationdate><title>Effect of Finasteride on the Sensitivity of PSA for Detecting Prostate Cancer</title><author>Thompson, Ian M. ; Chi, Chen ; Ankerst, Donna Pauler ; Goodman, Phyllis J. ; Tangen, Catherine M. ; Lippman, Scott M. ; Lucia, M. Scott ; Parnes, Howard L. ; Coltman, Charles A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c485t-c07bf4f0e5b1d86446b23f48f02e18f4f84327e42742a2036bb7a291c199fdae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aged</topic><topic>Area Under Curve</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>Clinical outcomes</topic><topic>Diagnostic tests</topic><topic>Disease prevention</topic><topic>Drug therapy</topic><topic>Enzyme Inhibitors - pharmacology</topic><topic>Finasteride - pharmacology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Predictive Value of Tests</topic><topic>Prostate cancer</topic><topic>Prostate-Specific Antigen - blood</topic><topic>Prostatic Hyperplasia - diagnosis</topic><topic>Prostatic Hyperplasia - immunology</topic><topic>Prostatic Neoplasms - diagnosis</topic><topic>Prostatic Neoplasms - immunology</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatitis - diagnosis</topic><topic>Prostatitis - immunology</topic><topic>Research Design</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Tumors</topic><topic>Tumors of the urinary system</topic><topic>Urinary tract. Prostate gland</topic><topic>Validation studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thompson, Ian M.</creatorcontrib><creatorcontrib>Chi, Chen</creatorcontrib><creatorcontrib>Ankerst, Donna Pauler</creatorcontrib><creatorcontrib>Goodman, Phyllis J.</creatorcontrib><creatorcontrib>Tangen, Catherine M.</creatorcontrib><creatorcontrib>Lippman, Scott M.</creatorcontrib><creatorcontrib>Lucia, M. Scott</creatorcontrib><creatorcontrib>Parnes, Howard L.</creatorcontrib><creatorcontrib>Coltman, Charles A.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>JNCI : Journal of the National Cancer Institute</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thompson, Ian M.</au><au>Chi, Chen</au><au>Ankerst, Donna Pauler</au><au>Goodman, Phyllis J.</au><au>Tangen, Catherine M.</au><au>Lippman, Scott M.</au><au>Lucia, M. Scott</au><au>Parnes, Howard L.</au><au>Coltman, Charles A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Finasteride on the Sensitivity of PSA for Detecting Prostate Cancer</atitle><jtitle>JNCI : Journal of the National Cancer Institute</jtitle><addtitle>JNCI J Natl Cancer Inst</addtitle><date>2006-08-16</date><risdate>2006</risdate><volume>98</volume><issue>16</issue><spage>1128</spage><epage>1133</epage><pages>1128-1133</pages><issn>0027-8874</issn><eissn>1460-2105</eissn><coden>JNCIEQ</coden><abstract>Background: In the Prostate Cancer Prevention Trial (PCPT), men receiving finasteride had a 24.8% lower risk of prostate cancer than men receiving placebo but a higher risk of high-grade cancer. We examined the impact of finasteride on the sensitivity and area under the receiver operating characteristic curve (AUC) of prostate-specific antigen (PSA) for detecting prostate cancer. Methods: We studied men in the placebo and finasteride groups of the PCPT who had a prostate biopsy and concurrent PSA tests during the 7-year study. We compared the placebo and finasteride groups for sensitivity and AUC of PSA for the detection of all prostate cancer, of Gleason grade 7 or higher prostate cancer, and of Gleason grade 8 or higher prostate cancer. All statistical tests were two-sided. Results: Of 5112 men in the placebo group, prostate cancer was detected in 1111. Gleason tumor grade was available for 1100 men, of whom 240 had grade 7 or higher and 55 had grade 8 or higher. Of 4579 men in the finasteride group, 695 had prostate cancer. Gleason grade was available for 686 men, of whom 264 had grade 7 or higher and 81 had grade 8 or higher. The AUC of PSA for all outcomes was greater for the finasteride group than the placebo group. For detecting prostate cancer versus no cancer, the AUCs were 0.757 and 0.681, respectively (P<.001); for detecting Gleason grade ≥7 versus ≤6 or no cancer, the AUCs were 0.838 and 0.781, respectively (P = .003); and for detecting Gleason grade ≥8 versus ≤7 or no cancer, the AUCs were 0.886 and 0.824, respectively (P = .071). The sensitivity of PSA was higher for men in the finasteride group than in the placebo group at all PSA cutoffs matched by specificity. Conclusions: PSA had statistically significantly better sensitivity and AUC for detecting prostate cancer in the finasteride arm of the PCPT than in the placebo arm. This bias would be expected to contribute to greater detection of all grades of prostate cancer with finasteride.</abstract><cop>Cary, NC</cop><pub>Oxford University Press</pub><pmid>16912265</pmid><doi>10.1093/jnci/djj307</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Area Under Curve Biological and medical sciences Biopsy Clinical outcomes Diagnostic tests Disease prevention Drug therapy Enzyme Inhibitors - pharmacology Finasteride - pharmacology Humans Male Medical sciences Middle Aged Nephrology. Urinary tract diseases Predictive Value of Tests Prostate cancer Prostate-Specific Antigen - blood Prostatic Hyperplasia - diagnosis Prostatic Hyperplasia - immunology Prostatic Neoplasms - diagnosis Prostatic Neoplasms - immunology Prostatic Neoplasms - pathology Prostatitis - diagnosis Prostatitis - immunology Research Design ROC Curve Sensitivity and Specificity Tumors Tumors of the urinary system Urinary tract. Prostate gland Validation studies |
| title | Effect of Finasteride on the Sensitivity of PSA for Detecting Prostate Cancer |
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