Suspected PCa pre-biopsy
Pre-biopsy (abnormal DRE / elevated PSA)
1. Cancer Risk Calculator for prostate cancer
A risk calculator is available for men with suspected PCa based on an abnormal DRE or elevated PSA. It predicts the probability of a positive biopsy, including the probability of a high grade (high Gleason score) biopsy. It takes into account
- family history of PCa
- DRE outcome
- serum PSA
- whether or not a prior biopsy was negative.
This risk calculator is based on the Prostate Cancer Prevention Trial (PCPT) . In this study, 5519 older American men with a relatively low PSA ( ≤ 3 ng/mL) who did not receive active treatment for 7 years had a 6-core biopsy.
More information: http://www.compass.fhcrc.org/edrnnci/bin/calculator/main.asp
The risk calculator has very recently been updated and now also includes the PCA3 Score. For more information see http://deb.uthscsa.edu/URORiskCalc/Pages/calcsPCA3.jsp
2. Prostate Risk Indicator
This risk calculator currently consists of 4 prostate risk indicators. The first 3 predict the probability of a positive biopsy. They take into account
Risk indicator 1
2.family history of PCa
3.frequency of urinary symptoms according to the International Prostate Symptom Score (I-PSS)
Risk indicator 2
Risk indicator 3
2.presence or absence of hypoechogenic lesions during transrectal ultrasonography (TRUS)
The Prostate Risk Indicator is based on data from 6288 Dutch men aged 55-74 years living in Rotterdam and participating in the European Randomized Study of Screening for Prostate Cancer (ERSPC) . These men were tested for serum PSA and for any prostate abnormalities by DRE and TRUS and were subsequently followed-up over time.
More information: http://www.prostate-riskindicator.com/via.html
 Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL et al. Prevalence of prostate cancer among men with a prostate-specific antigen level < or = 4.0 ng per milliliter. N Engl J Med 2004;350: 2239-46.
 Roobol MJ, Schröder FH, Kranse R, ERSPC, Rotterdam. A comparison of first and repeat (four years later) prostate cancer screening in a randomized cohort of symptomatic men aged 55-75 years using a biopsy indication of 3.0 ng/ml (results of ERSPC, Rotterdam). Prostate 2006;66:604-12.