MP63-13 REPEAT PROSTATE-SPECIFIC ANTIGEN TESTING REDUCES UNNECESSARY PROSTATE BIOPSIES.

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening III1 Apr 2014MP63-13 REPEAT PROSTATE-SPECIFIC ANTIGEN TESTING REDUCES UNNECESSARY PROSTATE BIOPSIES. Andrew Binette, Kelsey Witiuk, Ranjeeta Mallick, Chris Morash, Ilias Cagiannos, Luke Lavallee, and Rodney Breau Andrew BinetteAndrew Binette More articles by this author , Kelsey WitiukKelsey Witiuk More articles by this author , Ranjeeta MallickRanjeeta Mallick More articles by this author , Chris MorashChris Morash More articles by this author , Ilias CagiannosIlias Cagiannos More articles by this author , Luke LavalleeLuke Lavallee More articles by this author , and Rodney BreauRodney Breau More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1950AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The impact of repeating a prostate-specific antigen (PSA) test in a patient with a single abnormal value has been inadequately studied. Our primary objective was to evaluate the effect of an automatic repeat PSA in patients referred to a regional cancer diagnostic centre with an abnormal PSA value. METHODS All patients seen at The Ottawa Regional Prostate Cancer Assessment Clinic from April 2008 to May 2013 were reviewed. As per protocol, all patients were requested to obtain a repeat PSA prior to their consultation. Patients referred with a PSA ≥10 ng/L, a previous prostate biopsy, normal initial PSA value, or greater than 3 months between PSA tests were excluded. Patient age, prostate exam findings, and PSA values were obtained. Any prostate biopsy within 1 year following initial consultation was included. RESULTS Of the 1758 patients seen during the study period, 1271 (72%) met inclusion criteria and had a PSA at referral between 4 and 10 ng/L. Mean age was 64.3±8.4, mean first PSA was 6.3±1.6, and mean second PSA was 9.8±150.7. The repeated PSA was normal (<4ng/L) in 315 (25%) patients. A prostate biopsy was performed in 594 (62%) patients with an abnormal repeat PSA compared to 89 (28%) patients with a normal repeat PSA (RR of biopsy associated with abnormal repeat 2.20; CI 1.8-2.6; p<0.001). When the repeat PSA was abnormal, 57% of biopsies detected cancer and 31% detected Gleason ≥7 cancer. When the repeat PSA was normal, only 29% detected cancer (RR 0.52; CI 0.4-0.7; p<0.0001) and 11% detected Gleason ≥7 cancer (RR 0.69; CI 0.4-1.1; p=0.15). Analyses using age-specific and 2.5ng/L PSA thresholds had similar associations and will be presented. CONCLUSIONS Repeat PSA testing in patients with an abnormal screening PSA is clinically useful. A normal second PSA is associated with decreased risk of prostate biopsy and prostate cancer diagnosis. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e713 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Andrew Binette More articles by this author Kelsey Witiuk More articles by this author Ranjeeta Mallick More articles by this author Chris Morash More articles by this author Ilias Cagiannos More articles by this author Luke Lavallee More articles by this author Rodney Breau More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...