scholarly journals Prostate Cancer Risk Calculator Apps in a Taiwanese Population Cohort: Validation Study (Preprint)

2019 ◽  
Author(s):  
I-Hsuan Alan Chen ◽  
Chi-Hsiang Chu ◽  
Jen-Tai Lin ◽  
Jeng-Yu Tsai ◽  
Chia-Cheng Yu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Risk ◽  
Clinical Decision Making ◽  
Prostate Cancer Risk ◽  
Low Grade ◽  
High Grade ◽  
Risk Calculator ◽  
Taiwanese Population ◽  
Goodness Of Fit Test ◽  
Significant Difference

BACKGROUND Mobile health apps have emerged as useful tools for patients and clinicians alike, sharing health information or assisting in clinical decision-making. Prostate cancer (PCa) risk calculator mobile apps have been introduced to assess risks of PCa and high-grade PCa (Gleason score ≥7). The Rotterdam Prostate Cancer Risk Calculator and Coral–Prostate Cancer Nomogram Calculator apps were developed from the 2 most-studied PCa risk calculators, the European Randomized Study of Screening for Prostate Cancer (ERSPC) and the North American Prostate Cancer Prevention Trial (PCPT) risk calculators, respectively. A systematic review has indicated that the Rotterdam and Coral apps perform best during the prebiopsy stage. However, the epidemiology of PCa varies among different populations, and therefore, the applicability of these apps in a Taiwanese population needs to be evaluated. This study is the first to validate the PCa risk calculator apps with both biopsy and prostatectomy cohorts in Taiwan. OBJECTIVE The study’s objective is to validate the PCa risk calculator apps using a Taiwanese cohort of patients. Additionally, we aim to utilize postprostatectomy pathology outcomes to assess the accuracy of both apps with regard to high-grade PCa. METHODS All male patients who had undergone transrectal ultrasound prostate biopsies in a single Taiwanese tertiary medical center from 2012 to 2018 were identified retrospectively. The probabilities of PCa and high-grade PCa were calculated utilizing the Rotterdam and Coral apps, and compared with biopsy and prostatectomy results. Calibration was graphically evaluated with the Hosmer-Lemeshow goodness-of-fit test. Discrimination was analyzed utilizing the area under the receiver operating characteristic curve (AUC). Decision curve analysis was performed for clinical utility. RESULTS Of 1134 patients, 246 (21.7%) were diagnosed with PCa; of these 246 patients, 155 (63%) had high-grade PCa, according to the biopsy results. After confirmation with prostatectomy pathological outcomes, 47.2% (25/53) of patients were upgraded to high-grade PCa, and 1.2% (1/84) of patients were downgraded to low-grade PCa. Only the Rotterdam app demonstrated good calibration for detecting high-grade PCa in the biopsy cohort. The discriminative ability for both PCa (AUC: 0.779 vs 0.687; DeLong’s method: <i>P</i>&lt;.001) and high-grade PCa (AUC: 0.862 vs 0.758; <i>P</i>&lt;.001) was significantly better for the Rotterdam app. In the prostatectomy cohort, there was no significant difference between both apps (AUC: 0.857 vs 0.777; <i>P</i>=.128). CONCLUSIONS The Rotterdam and Coral apps can be applied to the Taiwanese cohort with accuracy. The Rotterdam app outperformed the Coral app in the prediction of PCa and high-grade PCa. Despite the small size of the prostatectomy cohort, both apps, to some extent, demonstrated the predictive capacity for true high-grade PCa, confirmed by the whole prostate specimen. Following our external validation, the Rotterdam app might be a good alternative to help detect PCa and high-grade PCa for Taiwanese men.

scholarly journals Prostate Cancer Risk Calculator Apps in a Taiwanese Population Cohort: Validation Study

10.2196/16322 ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. e16322
Author(s):  
I-Hsuan Alan Chen ◽  
Chi-Hsiang Chu ◽  
Jen-Tai Lin ◽  
Jeng-Yu Tsai ◽  
Chia-Cheng Yu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Risk ◽  
Clinical Decision Making ◽  
Prostate Cancer Risk ◽  
Low Grade ◽  
High Grade ◽  
Risk Calculator ◽  
Taiwanese Population ◽  
Goodness Of Fit Test ◽  
Significant Difference

Background Mobile health apps have emerged as useful tools for patients and clinicians alike, sharing health information or assisting in clinical decision-making. Prostate cancer (PCa) risk calculator mobile apps have been introduced to assess risks of PCa and high-grade PCa (Gleason score ≥7). The Rotterdam Prostate Cancer Risk Calculator and Coral–Prostate Cancer Nomogram Calculator apps were developed from the 2 most-studied PCa risk calculators, the European Randomized Study of Screening for Prostate Cancer (ERSPC) and the North American Prostate Cancer Prevention Trial (PCPT) risk calculators, respectively. A systematic review has indicated that the Rotterdam and Coral apps perform best during the prebiopsy stage. However, the epidemiology of PCa varies among different populations, and therefore, the applicability of these apps in a Taiwanese population needs to be evaluated. This study is the first to validate the PCa risk calculator apps with both biopsy and prostatectomy cohorts in Taiwan. Objective The study’s objective is to validate the PCa risk calculator apps using a Taiwanese cohort of patients. Additionally, we aim to utilize postprostatectomy pathology outcomes to assess the accuracy of both apps with regard to high-grade PCa. Methods All male patients who had undergone transrectal ultrasound prostate biopsies in a single Taiwanese tertiary medical center from 2012 to 2018 were identified retrospectively. The probabilities of PCa and high-grade PCa were calculated utilizing the Rotterdam and Coral apps, and compared with biopsy and prostatectomy results. Calibration was graphically evaluated with the Hosmer-Lemeshow goodness-of-fit test. Discrimination was analyzed utilizing the area under the receiver operating characteristic curve (AUC). Decision curve analysis was performed for clinical utility. Results Of 1134 patients, 246 (21.7%) were diagnosed with PCa; of these 246 patients, 155 (63%) had high-grade PCa, according to the biopsy results. After confirmation with prostatectomy pathological outcomes, 47.2% (25/53) of patients were upgraded to high-grade PCa, and 1.2% (1/84) of patients were downgraded to low-grade PCa. Only the Rotterdam app demonstrated good calibration for detecting high-grade PCa in the biopsy cohort. The discriminative ability for both PCa (AUC: 0.779 vs 0.687; DeLong’s method: P<.001) and high-grade PCa (AUC: 0.862 vs 0.758; P<.001) was significantly better for the Rotterdam app. In the prostatectomy cohort, there was no significant difference between both apps (AUC: 0.857 vs 0.777; P=.128). Conclusions The Rotterdam and Coral apps can be applied to the Taiwanese cohort with accuracy. The Rotterdam app outperformed the Coral app in the prediction of PCa and high-grade PCa. Despite the small size of the prostatectomy cohort, both apps, to some extent, demonstrated the predictive capacity for true high-grade PCa, confirmed by the whole prostate specimen. Following our external validation, the Rotterdam app might be a good alternative to help detect PCa and high-grade PCa for Taiwanese men.

Inflammatory and insulinemic dietary patterns: Influence on circulating biomarkers and prostate cancer risk in the prostate, lung, colorectal and ovarian cancer (PLCO) cohort.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17561-e17561
Author(s):  
Desmond Aroke ◽  
Edmund Folefac ◽  
Qi Jin ◽  
Ni Shi ◽  
Steven K. Clinton ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Risk ◽  
Dietary Patterns ◽  
Cox Regression ◽  
Prostate Cancer Risk ◽  
Low Grade ◽  
High Grade ◽  
C Peptide ◽  
Prostate Carcinogenesis ◽  
Hazard Ratios

e17561 Background: Prostate cancer (PCa) is common in countries with affluent dietary patterns and represents a heterogeneous collection of subtypes with varying behavior. Reductionist strategies focusing on individual nutrients or foods have not clearly defined risk factors. We have developed mechanisms-based dietary patterns focusing upon inflammation and chronic insulin hypersecretion, processes that are hypothesized to impact prostate carcinogenesis. Methods: First, we examined associations of the empirical dietary index for hyperinsulinemia (EDIH) and empirical dietary inflammatory pattern (EDIP) scores with circulating concentrations of relevant biomarkers, to assess the validity of these two dietary patterns. Secondly, we investigated associations of the EDIH and EDIP with risk of PCa (total, low-grade, high-grade, advanced and lethal). EDIH and EDIP dietary scores calculated from food frequency questionnaire data for 3,517 men and women who provided a blood sample at enrollment, were used to validate dietary patterns against known relevant biomarkers. A separate sample of 49,317 men was used to evaluate the associations of EDIH and EDIP with prostate cancer risk. We used multivariable-adjusted linear regression to compute the percent change and 95% confidence intervals (95%CI) in biomarker concentrations, and Cox regression to estimate hazard ratios (HR) and 95%CI for PCa risk; in dietary score quintiles, using the lowest quintile as reference. Results: Compared to the lowest quintile, participants in the highest EDIH quintile (most hyperinsulinemic diets) had significantly higher concentrations of C-peptide, insulin, CRP, and TNF-R2 and lower adiponectin. Those consuming the most pro-inflammatory diets (EDIP) had significantly higher concentrations of IL-6, TNF-R2, C-peptide and insulin with lower adiponectin. Men classified in EDIH quintile 5 compared to 1, were also at higher total PCa risk: HR, 1.11; 95%CI, 1.01, 1.23; P-trend = 0.03, especially high-grade cancer: HR, 1.18; 95%CI, 1.02, 1.37; P-trend = 0.06; whereas the EDIP was not associated with risk. Conclusions: EDIH and EDIP predicted concentrations of biomarkers relevant to the insulinemic and inflammatory potential of diet in PLCO. EDIH predicted future PCa risk and may suggest a dietary pattern for PCa prevention.

scholarly journals Anthropometric Measures and Risk of Prostate Cancer in the Multiethnic Cohort

2021 ◽  
Author(s):  
Olivia Sattayapiwat ◽  
Peggy Wan ◽  
Brenda Y Hernandez ◽  
Loic Le Marchand ◽  
Lynne Wilkens ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Risk ◽  
Advanced Prostate Cancer ◽  
Prostate Cancer Risk ◽  
Hazard Ratio ◽  
Low Grade ◽  
High Grade ◽  
Anthropometric Measures ◽  
Multiethnic Cohort ◽  
Increased Risk

Abstract Studies of anthropometric measures and prostate cancer risk conducted primarily in White men have reported positive associations with advanced disease. We assessed body size in relation to incident prostate cancer risk in 79,950 men from the Multiethnic Cohort, with 8,819 cases identified over a 22-year period (1993-2015). Height was associated with increased risk of advanced prostate cancer (hazard ratio=1.24, 95% CI: 1.04, 1.48; ≥68 inches versus &lt;66 inches) and high-grade disease (hazard ratio=1.15, 95% CI: 1.02, 1.31). Compared to men of normal weight, men overweight at baseline were at higher risk of high-grade cancer (hazard ratio=1.15, 95% CI: 1.04, 1.26). Greater weight was positively associated with localized and low-grade disease in African Americans and Native Hawaiians (Pheterogeneity by race 0.0002 and 0.008 respectively). Weight change since age 21 was positively associated with high-grade disease (hazard ratio=1.20, 95% CI: 1.05, 1.37; for ≥40 lb vs 10 lb; Ptrend=0.005). Comparing highest versus lowest quartile, waist-to-hip ratio was associated with a 1.78-fold increase (95% CI: 1.28, 2.46) in the risk of advanced prostate cancer. Positive associations with the majority of anthropometric measures were observed in all five racial/ethnic groups, suggesting a general impact of anthropometric measures on risk across populations.

scholarly journals Marital Status and Prostate Cancer Incidence: A Pooled Analysis of 12 Case-Control Studies From the PRACTICAL Consortium

2021 ◽  
Author(s):  
Charlotte Salmon ◽  
Lixin Song ◽  
Kenneth R Muir ◽  
Nora Pashayan ◽  
Alison M Dunning ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Social Support ◽  
Cancer Risk ◽  
Marital Status ◽  
Prostate Cancer Risk ◽  
Case Control ◽  
Cancer Prognosis ◽  
Low Grade ◽  
High Grade ◽  
Case Control Studies

Abstract While being in a committed relationship is associated with a better prostate cancer prognosis, little is known about how marital status relates to its incidence. Social support provided by marriage/relationship could promote a healthy lifestyle and an increased healthcare seeking behavior.We investigated the association between marital status and prostate cancer risk using data from the PRACTICAL Consortium. Pooled analyses were conducted combining 12 case-control studies based on histologically-confirmed incident prostate cancers and controls with information on marital status prior to diagnosis/interview. Marital status was categorized as married/partner, separated/divorced, single, or widowed. Tumours with Gleason scores ≥8 defined high-grade cancers, and low-grade otherwise. NCI-SEER’s summary stages (local, regional, distant) indicated the extent of the cancer. Logistic regression was used to derive odds ratios (ORs) and 95% confidence intervals (CI) for the association between marital status and prostate cancer risk, adjusting for potential confounders. Overall, 14,760 cases and 12,019 controls contributed to analyses. Compared to men who were married/with a partner, widowed men had an OR of 1.19 (95%CI 1.03-1.35) of prostate cancer, with little difference between low- and high-grade tumours. Risk estimates among widowers were 1.14 (95%CI 0.97-1.34) for local, 1.53 (95%CI 1.22-1.92) for regional, and 1.56 (95%CI 1.05-2.32) for distant stage tumours. Single men had elevated risks of high-grade cancers. Our findings highlight elevated risks of incident prostate cancer among widowers, more often characterized by tumours that had spread beyond the prostate at the time of diagnosis. Social support interventions and closer medical follow-up in this sub-population are warranted.

scholarly journals Next-generation prostate cancer risk calculator for primary care physicians

2017 ◽  
Vol 12 (2) ◽  
pp. E64-70 ◽  
Author(s):  
Robert K. Nam ◽  
Raj Satkunasivam ◽  
Joseph L. Chin ◽  
Jonathan Izawa ◽  
John Trachtenberg ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Risk ◽  
Life Expectancy ◽  
Prostate Biopsy ◽  
Primary Care Physicians ◽  
Prostate Cancer Risk ◽  
Concordance Index ◽  
Risk Calculator ◽  
Next Generation ◽  
Term Survival

Introduction: Current prostate cancer risk calculators are limited in impact because only a probability of having prostate cancer is provided. We developed the next generation of prostate cancer risk calculator that incorporates life expectancy in order to better evaluate prostate cancer risk in context to a patient’s age and comorbidity.Methods: We combined two cohorts to develop the new risk calculator. The first was 5638 subjects who all underwent a prostate biopsy for prostate cancer detection. The second was 979 men diagnosed with prostate cancer with long-term survival data. Two regression models were used to create multivariable nomograms and an online prostate cancer risk calculator was developed.Results: Of the 5638 patients who underwent a prostate biopsy, 629 (11%) were diagnosed with aggressive prostate cancer (Gleason Score 7[4+3] or more). Of the 979 patients who underwent treatment for prostate cancer, the 10-year overall survival (OS) was 49.6% (95% confidence interval [CI] 46.6‒52.9). The first multivariable nomogram for cancer risk had a concordance index of 0.74 (95% CI 0.72, 0.76), and the second nomogram to predict survival had a concordance index of 0.71 (95% CI 0.69‒0.72). The nextgeneration prostate cancer risk calculator was developed online and is available at: http://riskcalc.org/ProstateCA_Screen_Tool.Conclusions: We have developed the next-generation prostate cancer risk calculator that incorporates a patient’s life expectancy based on age and comorbidity. This approach will better evaluate prostate cancer risk. Future studies examining other populations will be needed for validation.

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