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...

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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
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spelling Evaluation of the 4Kscore Test in Relation to Subsequent Risk of Aggressive Prostate Cancer in the European Prospective Investigation into Cancer and NutritionSmith-Byrne, KarlFensom, Georgina K.Noor, UrwahWatts, Eleanor L.Allen, Naomi E.Amiano, PilarChirlaque, María DoloresCrous Bou, MartaGuevara Eslava, MarcelaPalli, DomenicoKatzke, VerenaSacerdote, CarlottaSánchez Pérez, María JoséSchulze, Matthias B.Sieri, SabinaTumino, RosarioTsilidis, Konstantinos K.Kaaks, RudolfGunter, Marc J.Riboli, ElioKey, Timothy J.Travis, Ruth C.Càncer de pròstataAntigen específic de la pròstataProstate cancerProstate-specific antigenBackground: 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.American Association for Cancer Research (AACR)2025202520252025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion10 p.application/pdfhttps://hdl.handle.net/2445/224462Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1158/1055-9965.EPI-24-1877Cancer Epidemiology Biomarkers & Prevention, 2025, vol. 34, num. 11, p. 2058-2067https://doi.org/10.1158/1055-9965.EPI-24-1877cc-by (c) Smith-Byrne, Karl et al., 2025http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2244622026-05-29T05:05:01Z
dc.title.none.fl_str_mv Evaluation of the 4Kscore Test in Relation to Subsequent Risk of Aggressive Prostate Cancer in the European Prospective Investigation into Cancer and Nutrition
title Evaluation of the 4Kscore Test in Relation to Subsequent Risk of Aggressive Prostate Cancer in the European Prospective Investigation into Cancer and Nutrition
spellingShingle Evaluation of the 4Kscore Test in Relation to Subsequent Risk of Aggressive Prostate Cancer in the European Prospective Investigation into Cancer and Nutrition
Smith-Byrne, Karl
Càncer de pròstata
Antigen específic de la pròstata
Prostate cancer
Prostate-specific antigen
title_short Evaluation of the 4Kscore Test in Relation to Subsequent Risk of Aggressive Prostate Cancer in the European Prospective Investigation into Cancer and Nutrition
title_full Evaluation of the 4Kscore Test in Relation to Subsequent Risk of Aggressive Prostate Cancer in the European Prospective Investigation into Cancer and Nutrition
title_fullStr Evaluation of the 4Kscore Test in Relation to Subsequent Risk of Aggressive Prostate Cancer in the European Prospective Investigation into Cancer and Nutrition
title_full_unstemmed Evaluation of the 4Kscore Test in Relation to Subsequent Risk of Aggressive Prostate Cancer in the European Prospective Investigation into Cancer and Nutrition
title_sort Evaluation of the 4Kscore Test in Relation to Subsequent Risk of Aggressive Prostate Cancer in the European Prospective Investigation into Cancer and Nutrition
dc.creator.none.fl_str_mv 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.
author Smith-Byrne, Karl
author_facet 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.
author_role author
author2 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.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Càncer de pròstata
Antigen específic de la pròstata
Prostate cancer
Prostate-specific antigen
topic Càncer de pròstata
Antigen específic de la pròstata
Prostate cancer
Prostate-specific antigen
description 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.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/224462
url https://hdl.handle.net/2445/224462
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1158/1055-9965.EPI-24-1877
Cancer Epidemiology Biomarkers & Prevention, 2025, vol. 34, num. 11, p. 2058-2067
https://doi.org/10.1158/1055-9965.EPI-24-1877
dc.rights.none.fl_str_mv cc-by (c) Smith-Byrne, Karl et al., 2025
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Smith-Byrne, Karl et al., 2025
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 10 p.
application/pdf
dc.publisher.none.fl_str_mv American Association for Cancer Research (AACR)
publisher.none.fl_str_mv American Association for Cancer Research (AACR)
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869414794246750208
score 15,812455

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