Testing Free PSA Percentage As a Tool in Predicting Future Risk of Developing Prostate Cancer: A System Wide Analysis of a Contemporary North American Cohort

You have accessJournal of UrologyProstate Cancer: Detection & Screening I (MP19)1 May 2024MP19-03 TESTING FREE PSA PERCENTAGE AS A TOOL IN PREDICTING FUTURE RISK OF DEVELOPING PROSTATE CANCER: A SYSTEM WIDE ANALYSIS OF A CONTEMPORARY NORTH AMERICAN COHORT Giuseppe O. Cirulli, Giuseppe Chiarelli, Marco Finati, Alex Stephens, Sohrab Arora, Patrick Etta, Davis Matthew, Shane Tinsley, Chase Morrison, Akshay Sood, Nicolò Buffi, Giovanni Lughezzani, Giuseppe Carrieri, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Craig Rogers, and Firas Abdollah Giuseppe O. CirulliGiuseppe O. Cirulli , Giuseppe ChiarelliGiuseppe Chiarelli , Marco FinatiMarco Finati , Alex StephensAlex Stephens , Sohrab AroraSohrab Arora , Patrick EttaPatrick Etta , Davis MatthewDavis Matthew , Shane TinsleyShane Tinsley , Chase MorrisonChase Morrison , Akshay SoodAkshay Sood , Nicolò BuffiNicolò Buffi , Giovanni LughezzaniGiovanni Lughezzani , Giuseppe CarrieriGiuseppe Carrieri , Andrea SaloniaAndrea Salonia , Alberto BrigantiAlberto Briganti , Francesco MontorsiFrancesco Montorsi , Craig RogersCraig Rogers , and Firas AbdollahFiras Abdollah View All Author Informationhttps://doi.org/10.1097/01.JU.0001008716.22569.77.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Free PSA percentage (%fPSA) has been proposed by AUA Guidelines as a useful serum marker in guiding biopsy decisions when further risk stratification is needed, especially in patients with mildly elevated PSA. On the other hand, it is not explicitly recommended to consider %fPSA as a tool to guide future PSA screening. We aimed to examine the potential role of %fPSA in predicting future development of PCa in a contemporary North American population. METHODS: Men aged 40–59 years, who received their %fPSA between the years 1995 and 2019 were included. These selection criteria resulted in a total of 1,308 patients. Based on previously published methodology, Free PSA % was categorized in 3 different groups (<10%, 10% to 25% and >25%). Main outcome was PCa incidence. Cumulative incidence curves were used to depict the risk of deveoloping PCa over time, based on %fPSA categories. Multivariable Fine-Gray regression was used to examine the role of %fPSA as a predictor of future development of PCa after adjusting for available confounders. RESULTS: In our cohort, patients were most frequently in the 55–59 age category (33.4%), had a CCI of 0 (67.1%), and were white (75.6%). Most patients (68.8%) had a %fPSA between 10% and 25%. The median (IQR) follow-up time was 2.9 (0.9-5.1) years. Within this period, 228 (17.4%) patients, developed PCa. At 5-year the risk of developing PCa in patients with a %fPSA <10% vs 10%-25% vs >25%, was 22.8% vs 8.9% vs 3.1%, respectively (p<0.001). On multivariable analysis, patients with a %fPSA <10%, had a 6.21-fold (95% CI: 3.62-10.64) higher risk of developing PCa when compared to those with a %fPSA >25% (p: <0.01). CONCLUSIONS: Our report is the first to examine the role of %fPSA in the PSA screening context. Our findings showed that %fPSA measured in men without PCa is an important predictor of the future risk of developing PCa. This suggests that %fPSA has practical utility in enhancing PSA screening strategies in clinical practice, where patients with highest risk of developing PCa can receive more intese screening, and vice versa. Download PPT Source of Funding: Vattikuti foundation and Menon foundation © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e310 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Giuseppe O. Cirulli More articles by this author Giuseppe Chiarelli More articles by this author Marco Finati More articles by this author Alex Stephens More articles by this author Sohrab Arora More articles by this author Patrick Etta More articles by this author Davis Matthew More articles by this author Shane Tinsley More articles by this author Chase Morrison More articles by this author Akshay Sood More articles by this author Nicolò Buffi More articles by this author Giovanni Lughezzani More articles by this author Giuseppe Carrieri More articles by this author Andrea Salonia More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Craig Rogers More articles by this author Firas Abdollah More articles by this author Expand All Advertisement PDF downloadLoading ...