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Prostate cancer risk prediction in a urology clinic in Mexico.
Liang, Yuanyuan; Messer, Jamie C; Louden, Christopher; Jimenez-Rios, Miguel A; Thompson, Ian M; Camarena-Reynoso, Hector R.
Afiliação
  • Liang Y; Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio (UTHSCSA), San Antonio, TX 78229, USA; Department of Urology, UTHSCSA, San Antonio, TX 78229, USA; School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA; Cancer Therapy and Research Center, UTHSCSA, San Antonio, TX 78229, USA. Electronic address: liangy@uthscsa.edu.
Urol Oncol ; 31(7): 1085-92, 2013 Oct.
Article em En | MEDLINE | ID: mdl-22306115
OBJECTIVES: To evaluate factors affecting the risk of prostate cancer (CaP) and high-grade disease (HGCaP, Gleason score ≥ 7) in a Mexican referral population, with comparison to the Prostate Cancer Prevention Trial Prostate Cancer Risk Calculator (PCPTRC). METHODS AND MATERIALS: From a retrospective study of 826 patients who underwent prostate biopsy between January 2005 and December 2009 at the Instituto Nacional de Cancerología, Mexico, logistic regression was used to assess the effects of age, prostate-specific antigen (PSA), digital rectal exam (DRE), first-degree family history of CaP, and history of a prior prostate biopsy on CaP and HGCaP, separately. Internal discrimination, goodness-of-fit, and clinical utility of the resulting models were assessed with comparison to the PCPTRC. RESULTS: Rates of both CaP (73.2%) and HGCaP (33.3%) were high among referral patients in this Mexican urology clinic. The PCPTRC generally underestimated the risk of CaP but overestimated the risk of HGCaP. Four factors influencing CaP on biopsy were logPSA, DRE, family history and a prior biopsy history (all P < 0.001). The internal AUC of the logistic model was 0.823 compared with 0.785 of the PCPTRC for CaP (P < 0.001). The same 4 factors were significantly associated with HGCaP as well and the AUC was 0.779 compared with 0.766 of the PCPTRC for HGCaP (P = 0.13). CONCLUSIONS: Lack of screening programs or regular urologic checkups in Mexico imply that men typically first reach specialized clinics with a high cancer risk. This renders diagnostic tools developed on comparatively healthy populations, such as the PCPTRC, of lesser utility. Continued efforts are needed to develop and externally validate new clinical diagnostic tools specific to high-risk referral populations incorporating new biomarkers and more clinical characteristics.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Próstata / Neoplasias da Próstata / Urologia / Instituições de Assistência Ambulatorial Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male / Middle aged País/Região como assunto: Mexico Idioma: En Revista: Urol Oncol Assunto da revista: NEOPLASIAS / UROLOGIA Ano de publicação: 2013 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Próstata / Neoplasias da Próstata / Urologia / Instituições de Assistência Ambulatorial Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male / Middle aged País/Região como assunto: Mexico Idioma: En Revista: Urol Oncol Assunto da revista: NEOPLASIAS / UROLOGIA Ano de publicação: 2013 Tipo de documento: Article País de publicação: Estados Unidos