With respect to the rest of the world, I think we need to urge caution. Men can use the Kattan nomograms rather than the Partin tables, for example (or both). But the bottom line is still going to be that all these predictive systems were developed using (at best) nationally-biased groups of patients, which MAY affect their application to other groups.

I know without a lot of work the issues cannot be identified.

Since we are talking to men all over the world how do we communicate about the Partin Tables?

Men and physicians have enough problems already have enough problems interpreting the information they have to make decisions about prostate cancer.

This just muddies the water even more. GRRRRRR

There are literally dozens of reasons why nomograms and tables like the Partin tables that are developed using data based on patient set A may not be as accurate for patient set B. The point of this study is that the German group actually proved it.

People should always be cautious about applying predictive tools of this type. One specific example of a predictive tool that is almost certainly NOT appropriate for use outside the USA is the Prostate Cancer Risk Calculator, which was develped on the basis of the PCPT trial data and therefore is entirely US oriented. Europeans (not to mention Argentinians, Russians, and Japanese) have very different diets and genetics to the “average” American. That alone undoubtedly impacts their risk in ways not addressed by the PCPT trial.