1909 URINE PCA3 TESTING FOR THE EARLY DETECTION OF PROSTATE CANCER. FEASIBILITY, TEST PERFORMANCE, AND AGE AND RACE ASSOCIATIONS COMPARED TO SERUM PSA IN A MULTI-ETHNIC POPULATION OVER FOUR YEARS

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You have accessJournal of UrologyProstate Cancer: Detection and Screening1 Apr 20111909 URINE PCA3 TESTING FOR THE EARLY DETECTION OF PROSTATE CANCER. FEASIBILITY, TEST PERFORMANCE, AND AGE AND RACE ASSOCIATIONS COMPARED TO SERUM PSA IN A MULTI-ETHNIC POPULATION OVER FOUR YEARS Kathleen Torkko, Adrie van Bokhoven, Paul Maroni, Scott Lucia, Suzanne McCartney, Holly Sullivan, John Fulmer, Scott Shappell, and David Crawford Kathleen TorkkoKathleen Torkko Aurora, CO More articles by this author , Adrie van BokhovenAdrie van Bokhoven Aurora, CO More articles by this author , Paul MaroniPaul Maroni Aurora, CO More articles by this author , Scott LuciaScott Lucia Aurora, CO More articles by this author , Suzanne McCartneySuzanne McCartney Aurora, CO More articles by this author , Holly SullivanHolly Sullivan Aurora, CO More articles by this author , John FulmerJohn Fulmer Dallas, TX More articles by this author , Scott ShappellScott Shappell Dallas, TX More articles by this author , and David CrawfordDavid Crawford Aurora, CO More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2047AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Serum PSA has inadequate sensitivity and specificity for prostate carcinoma(CaP) detected on biopsy. PCA3 is a prostate specific gene that is up-regulated in CaP. PCA3 urine mRNA test is a new diagnostic tool with much higher specificity for CaP than PSA that is increasingly used to determine the need for repeat biopsy. Its feasibility and performance have not been evaluated in a true screening setting. METHODS We evaluated PCA3 testing using the community-based Prostate Cancer Awareness Week screening population at the University of Colorado Denver over a four year period (2006–09). PCA3 Scores (PCA3/PSA mRNA x103) were determined from first catch urine collected after DRE by a varied group of clinicians. RESULTS Of 971 participants over 4 years, 72.9% were Caucasian (C), 16.3% African American (AA), and 8.3% Hispanic (H). C men tended to be older (mean 63.5 years) than AA (58.8) or H (58.4) men. PCA3 test informative rates were >96% in each year. In this screening population, PSA values ranged from <0.01–203.8 and PCA3 ranged from 0.3–316.2. Using the most recent test results, median PSA was 0.9, 0.9, and 0.6 ng/ml and median PCA3 score was 9.7, 14.6, 7.8 for C, AA, and H men, respectively. With test cutoffs of ≥2.5 ng/ml for PSA and ≥35 for PCA3, percent PSA+ men was 23.4% for C vs. 19.1% for AA, and 18.5% for H men. In contrast, despite younger age for AA vs. C men, the percent PCA3+ men was 35.7% in AA vs. 21.8% C men. Only 10% of H men were PCA3+. The proportions of PSA-/PCA3+ men was higher in AA (24.4%) compared to C (12.5%) and H (6.3%). PCA3 values in these men ranged from 35.3 to 316.2 (median 59.9). CONCLUSIONS The PCA3 assay can be successfully performed in a busy screening setting. The excellent informative rate for the test on the currently available transcription mediated amplification platform (Gen-Probe, Inc., San Diego, CA) shows the robustness of this test after screening DRE. The predictive performance for CaP on bx, including of PSA and PCA3 as continuous variables, remains to be further established. Given the high proportion of men in the Prostate Cancer Prevention Trial who had normal PSA values but had cancer on the end-of-study bx, positive PCA3 tests in men with normal PSAs may be useful to increase specificity of PSA testing, and to detect clinically significant CaP in these patients. As AA men are at highest risk for CaP and have more aggressive CaP, the consistent observation of a higher proportion of AA men with normal serum PSA and positive PCA3 score may help improve early detection in AA men. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e763 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kathleen Torkko Aurora, CO More articles by this author Adrie van Bokhoven Aurora, CO More articles by this author Paul Maroni Aurora, CO More articles by this author Scott Lucia Aurora, CO More articles by this author Suzanne McCartney Aurora, CO More articles by this author Holly Sullivan Aurora, CO More articles by this author John Fulmer Dallas, TX More articles by this author Scott Shappell Dallas, TX More articles by this author David Crawford Aurora, CO More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...