Skip to main content Skip to main navigation menu Skip to site footer

Prostate specific antigen-age volume score in predicting prostate cancer among the Indonesian population

  • Agus Rizal Ardy Hariandy Hamid ,
  • Putu Angga Risky Raharja ,
  • Fakhri Rahman ,
  • Chaidir Arif Mochtar ,
  • Rainy Umbas ,


Abstract

Link of Video Abstract: https://youtu.be/ZNusQRjFEH0

 

Introduction: Several methods have been explored to increase the effectiveness of prostate-specific antigen (PSA) for prostate cancer screening. A lower prostate-specific antigen-age volume (PSA-AV) score is associated with higher cancer risk. This study aimed to evaluate the value of PSA-AV scores in the detection of prostate cancer among the Indonesian population.

Methods: A retrospective study was conducted on 844 prostate biopsies performed at our center between January 2015 and December 2019. The score of PSA-AV was derived by multiplication of the patient's age and prostate volume and then division with PSA level. A ROC curve analysis was conducted to determine the cutoff for the PSA-AV score. The sensitivities and specificities of the PSA-AV score were contrasted with total PSA, PSA density, and age-adjusted PSA.

Results: The mean age of the patient was 63.63±8.6 years, with a mean PSA of 16.3±13.9 ng/mL and a mean volume of 42.7±16.0 cm3. Among 844 biopsies, 25.5% tested positive for prostate cancer. Prostate cancer patients had significantly higher mean age, PSA levels, and positive digital rectal examinations (P<0.05). In predicting prostate cancer, the PSA-AV score demonstrated a higher AUC of 0.772, surpassing the AUC of 0.762 achieved by the total PSA. The analysis identified a cutoff of 700 for the PSA-AV score, which showed significant sensitivity (94%) and sufficient specificity (8.4%). These values outperformed the total PSA cutoff of 4 ng/mL (sensitivity 91.6%; specificity 5.4%), PSA density cutoff of 0.15 (sensitivity 85.1%; specificity 30.0%), and age-adjusted PSA cutoff (sensitivity 88.4%; specificity 11.8%). The superiority of the PSA-AV score of <700 was more prominent in the subgroup analysis of patients below 70 years of age and those with a low-moderate prostate volume (<60 cm3).

Conclusions: The PSA-AV score demonstrated superior sensitivities and specificities compared to total PSA, PSA density, and age-adjusted PSA. Therefore, it is recommended to utilize a PSA-AV score of <700, particularly for men below 70 years of age with low-moderate prostate volumes (< 60 cm3).

Keywords: prostate biopsy prostate cancer prostate specific antigen PSA-age volume score

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.
  2. Umbas R, Safriadi F, Mochtar CA, Djatisoesanto W, Hamid ARAH. Urologic cancer in Indonesia. Jpn J Clin Oncol. 2015;45(8):708–12.
  3. Mochtar CA, Atmoko W, Umbas R, Hamid ARAH. Prostate cancer detection rate in Indonesian men. Asian J Surg. 2018 Mar;41(2):163–9.
  4. Ucer O, Yucetas U, Celen I, Toktas G, Muezzinoglu T. Assessment of PSA-Age volume score in predicting positive prostate biopsy findings in Turkey. Int Braz J Urol. 2015;41(5):864–8.
  5. Patel S, Issa MM, El-galley R. Evaluation of Novel Formula of PSA, Age, Prostate Volume, and Race in Predicting Positive Prostate Biopsy Findings. Urology [Internet]. 2013;81(3):602–6. Available from: http://dx.doi.org/10.1016/j.urology.2012.10.047
  6. Mistry K, Cable G. Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma. J Am Board Fam Pract. 2003;16(2):95–101.
  7. Wagenlehner FME, van Oostrum E, Tenke P, Tandogdu Z, Cek M, Grabe M, et al. Infective complications after prostate biopsy: outcome of the Global Prevalence Study of Infections in Urology (GPIU) 2010 and 2011, a prospective multinational multicentre prostate biopsy study. Eur Urol. 2013 Mar;63(3):521–7.
  8. Wu YS, Wu XB, Zhang N, Jiang GL, Yu Y, Tong SJ. Evaluation of PSA ‑ age volume score in predicting prostate cancer in Chinese population. 2018;(November 2017):324–9.
  9. Shahab AA, Soebadi DM, Djatisoesanto W, Hardjowijoto S, Soetojo S, Hakim L. Prostate-specific antigen and prostate-specific antigen density cutoff points among Indonesian population suspected for prostate cancer. Prostate Int. 2013;1(1):23–30.
  10. Oesterling JE, Jacobsen SJ, Chute CG, Guess HA, Girman CJ, Panser LA, et al. Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges. JAMA. 1993 Aug;270(7):860–4.
  11. Bazinet M, Meshref AW, Trudel C, Aronson S, Peloquin F, Nachabe M, et al. Prospective evaluation of prostate-specific antigen density and systematic biopsies for early detection of prostatic carcinoma. Urology. 1994 Jan;43(1):42–4.
  12. Catalona WJ, Smith DS, Ratliff TL, Basler JW. Detection of organ-confined prostate cancer is increased through prostate-specific antigen-based screening. JAMA. 1993 Aug;270(8):948–54.
  13. Etzioni R, Penson DF, Legler JM, di Tommaso D, Boer R, Gann PH, et al. Overdiagnosis due to prostate-specific antigen screening: lessons from U.S. prostate cancer incidence trends. J Natl Cancer Inst. 2002 Jul;94(13):981–90.

How to Cite

Hamid, A. R. A. H. ., Raharja, P. A. R. ., Rahman, F. ., Mochtar, C. A. ., & Umbas, R. . (2023). Prostate specific antigen-age volume score in predicting prostate cancer among the Indonesian population. Bali Medical Journal, 12(2), 1740–1744. https://doi.org/10.15562/bmj.v12i2.4517
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
13

Total
6

Share

Search Panel

Agus Rizal Ardy Hariandy Hamid
Google Scholar
Pubmed
BMJ Journal

Putu Angga Risky Raharja
Google Scholar
Pubmed
BMJ Journal

Fakhri Rahman
Google Scholar
Pubmed
BMJ Journal

Chaidir Arif Mochtar
Google Scholar
Pubmed
BMJ Journal

Rainy Umbas
Google Scholar
Pubmed
BMJ Journal