Dataset Information

Prediction of future risk of any and higher-grade prostate cancer based on the PLCO and SELECT trials.

ABSTRACT:

Background

A model was built that characterized effects of individual factors on five-year prostate cancer (PCa) risk in the Prostate, Lung, Colon, and Ovarian Cancer Screening Trial (PLCO) and the Selenium and Vitamin E Cancer Prevention Trial (SELECT). This model was validated in a third San Antonio Biomarkers of Risk (SABOR) screening cohort.

Methods

A prediction model for 1- to 5-year risk of developing PCa and Gleason > 7 PCa (HG PCa) was built on PLCO and SELECT using the Cox proportional hazards model adjusting for patient baseline characteristics. Random forests and neural networks were compared to Cox proportional hazard survival models, using the trial datasets for model building and the SABOR cohort for model evaluation. The most accurate prediction model is included in an online calculator.

Results

The respective rates of PCa were 8.9%, 7.2%, and 11.1% in PLCO (n = 31,495), SELECT (n = 35,507), and SABOR (n = 1790) over median follow-up of 11.7, 8.1 and 9.0 years. The Cox model showed higher prostate-specific antigen (PSA), BMI and age, and African American race to be associated with PCa and HGPCa. Five-year risk predictions from the combined SELECT and PLCO model effectively discriminated risk in the SABOR cohort with C-index 0.76 (95% CI [0.72, 0.79]) for PCa, and 0.74 (95% CI [0.65,0.83]) for HGPCa.

Conclusions

A 1- to 5-year PCa risk prediction model developed from PLCO and SELECT was validated with SABOR and implemented online. This model can individualize and inform shared screening decisions.

SUBMITTER: Gelfond JA

PROVIDER: S-EPMC8966358 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Publications

Prediction of future risk of any and higher-grade prostate cancer based on the PLCO and SELECT trials.

Gelfond Jonathan A JA Hernandez Brian B Goros Martin M Ibrahim Joseph G JG Chen Ming-Hui MH Sun Wei W Leach Robin J RJ Kattan Michael W MW Thompson Ian M IM Ankerst Donna Pauler DP Liss Michael M

BMC urology 20220326 1

<h4>Background</h4>A model was built that characterized effects of individual factors on five-year prostate cancer (PCa) risk in the Prostate, Lung, Colon, and Ovarian Cancer Screening Trial (PLCO) and the Selenium and Vitamin E Cancer Prevention Trial (SELECT). This model was validated in a third San Antonio Biomarkers of Risk (SABOR) screening cohort.<h4>Methods</h4>A prediction model for 1- to 5-year risk of developing PCa and Gleason > 7 PCa (HG PCa) was built on PLCO and SELECT using the Co ...[more]

PMID: 35351104

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Project description:Background:The ERSPC (European Randomized Study of Screening for Prostate Cancer) found that screening reduced prostate cancer mortality, but the PLCO (Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial) found no reduction. Objective:To evaluate whether effects of screening on prostate cancer mortality relative to no screening differed between the ERSPC and PLCO. Design:Cox regression of prostate cancer death in each trial group, adjusted for age and trial. Extended analyses accounted for increased incidence due to screening and diagnostic work-up in each group via mean lead times (MLTs), which were estimated empirically and using analytic or microsimulation models. Setting:Randomized controlled trials in Europe and the United States. Participants:Men aged 55 to 69 (ERSPC) or 55 to 74 (PLCO) years at randomization. Intervention:Prostate cancer screening. Measurements:Prostate cancer incidence and survival from randomization; prostate cancer incidence in the United States before screening began. Results:Estimated MLTs were similar in the ERSPC and PLCO intervention groups but were longer in the PLCO control group than the ERSPC control group. Extended analyses found no evidence that effects of screening differed between trials (P = 0.37 to 0.47 [range across MLT estimation approaches]) but strong evidence that benefit increased with MLT (P = 0.0027 to 0.0032). Screening was estimated to confer a 7% to 9% reduction in the risk for prostate cancer death per year of MLT. This translated into estimates of 25% to 31% and 27% to 32% lower risk for prostate cancer death with screening as performed in the ERSPC and PLCO intervention groups, respectively, compared with no screening. Limitation:The MLT is a simple metric of screening and diagnostic work-up. Conclusion:After differences in implementation and settings are accounted for, the ERSPC and PLCO provide compatible evidence that screening reduces prostate cancer mortality. Primary Funding Source:National Cancer Institute.

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Dataset Information

Prediction of future risk of any and higher-grade prostate cancer based on the PLCO and SELECT trials.

Background

Methods

Results

Conclusions

Publications

Prediction of future risk of any and higher-grade prostate cancer based on the PLCO and SELECT trials.

Similar Datasets

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