Evaluation of the 4Kscore Test in Relation to Subsequent Risk of Aggressive Prostate Cancer in the European Prospective Investigation into Cancer and Nutrition

Background: PSA is central to referrals for prostate biopsy but has low specificity for aggressive prostate cancer. This study evaluates the 4Kscore (OPKO Diagnostics) versus total PSA in predicting short- and long-term risks of aggressive prostate cancer. Methods: Baseline blood samples from 1,658...

Descripción completa

Detalles Bibliográficos
Autores: Smith-Byrne, Karl, Fensom, Georgina K., Noor, Urwah, Watts, Eleanor L., Allen, Naomi E., Amiano, Pilar, Chirlaque, María Dolores, Crous Bou, Marta, Guevara Eslava, Marcela, Palli, Domenico, Katzke, Verena, Sacerdote, Carlotta, Sánchez Pérez, María José, Schulze, Matthias B., Sieri, Sabina, Tumino, Rosario, Tsilidis, Konstantinos K., Kaaks, Rudolf, Gunter, Marc J., Riboli, Elio, Key, Timothy J., Travis, Ruth C.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/224462
Acceso en línea:https://hdl.handle.net/2445/224462
Access Level:acceso abierto
Palabra clave:Càncer de pròstata
Antigen específic de la pròstata
Prostate cancer
Prostate-specific antigen
Descripción
Sumario:Background: PSA is central to referrals for prostate biopsy but has low specificity for aggressive prostate cancer. This study evaluates the 4Kscore (OPKO Diagnostics) versus total PSA in predicting short- and long-term risks of aggressive prostate cancer. Methods: Baseline blood samples from 1,658 men diagnosed with prostate cancer (median diagnosis time = 8.6 years) and 1,658 matched controls in the European Prospective Investigation into Cancer and Nutrition were analyzed. Discrimination for the 4Kscore and total PSA was assessed using the AUC with 95% confidence intervals (CI) via bootstrapping. Results: For high-grade tumors, AUCs were 0.69 (95% CI, 0.66-0.72) for the 4Kscore and 0.75 (95% CI, 0.73-0.78) for total PSA. For advanced-stage disease, AUCs were 0.71 (95% CI, 0.66-0.75) for the 4Kscore and 0.77 (95% CI, 0.73-0.80) for total PSA. Similar findings were observed for other aggressive cancer endpoints. Among men with PSA >2 ng/mL, the 4Kscore had better discrimination than PSA for overall prostate cancer, high-grade disease, and prostate cancer death but only in men <60 years at recruitment. Conclusions: In this large European study, the 4Kscore did not significantly improve the prediction of clinically significant prostate cancer compared with total PSA, except in younger men with elevated PSA. Impact: The findings underscore the limited utility of the 4Kscore in improving medium- to longer-term risk prediction over PSA, with potential benefits restricted to younger men with elevated PSA.

Similares en LA Referencia