Abstract
ObjectivesWe developed a mobile application-based Seoul National University Prostate Cancer Risk Calculator (SNUPC-RC) that predicts the probability of prostate cancer (PC) at the initial prostate biopsy in a Korean cohort. Additionally, the application was validated and subjected to head-to-head comparisons with internet-based Western risk calculators in a validation cohort. Here, we describe its development and validation.Patients and MethodsAs a retrospective study, consecutive men who underwent initial prostate biopsy with more than 12 cores at a tertiary center were included. In the development stage, 3,482 cases from May 2003 through November 2010 were analyzed. Clinical variables were evaluated, and the final prediction model was developed using the logistic regression model. In the validation stage, 1,112 cases from December 2010 through June 2012 were used. SNUPC-RC was compared with the European Randomized Study of Screening for PC Risk Calculator (ERSPC-RC) and the Prostate Cancer Prevention Trial Risk Calculator (PCPT-RC). The predictive accuracy was assessed using the area under the receiver operating characteristic curve (AUC). The clinical value was evaluated using decision curve analysis.ResultsPC was diagnosed in 1,240 (35.6%) and 417 (37.5%) men in the development and validation cohorts, respectively. Age, prostate-specific antigen level, prostate size, and abnormality on digital rectal examination or transrectal ultrasonography were significant factors of PC and were included in the final model. The predictive accuracy in the development cohort was 0.786. In the validation cohort, AUC was significantly higher for the SNUPC-RC (0.811) than for ERSPC-RC (0.768, p<0.001) and PCPT-RC (0.704, p<0.001). Decision curve analysis also showed higher net benefits with SNUPC-RC than with the other calculators.ConclusionsSNUPC-RC has a higher predictive accuracy and clinical benefit than Western risk calculators. Furthermore, it is easy to use because it is available as a mobile application for smart devices.
Highlights
Prostate cancer (PC) is the second most common cancer and is associated with the sixth highest cancer-related mortality in men worldwide [1]
accuracy of SNUPC-RC (AUC) was significantly higher for the SNUPC-RC (0.811) than for ERSPC-RC (0.768, p,0.001) and Prostate Cancer Prevention Trial Risk Calculator (PCPT-RC) (0.704, p,0.001)
All evaluated variables were significantly associated with detection of PC in univariate as well as multivariate logistic regression analyses (Table 2)
Summary
Prostate cancer (PC) is the second most common cancer and is associated with the sixth highest cancer-related mortality in men worldwide [1]. Incidence rates of PC have increased in most countries, except in a few developed Western countries. There is a clear trend of rapidly increasing PC incidence in Asian countries, including South Korea [2,3]. Proper diagnosis of PC is a major problem in Asian countries. The use of transrectal ultrasonography (TRUS)-guided prostate needle biopsy (TRUSBx) to diagnose PC is accompanied by significant morbidity and mortality and is a considerable socio-economic burden [4]. For these reasons, the decision of whether to conduct a biopsy is of the utmost importance in actual practice [5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
