Prostate cancer risk and the value of the PCPT risk calculator


A new study has clearly shown the value of the  Prostate Cancer Prevention Trial (PCPT) risk calculator in the evaluation of risk for prostate cancer in a cohort of young, racially diverse, high-risk men with a low baseline PSA level.

This particular study, reported by Kaplan et al., evaluated over 600 men who were enrolled in the Prostate Cancer Risk Assessment Program (PRAP). Eligibility for PRAP includes men aged from 35 to 69 years who meet one of the following criteria: African American ethnicity, having a family history of prostate cancer, or having a known BRCA1/2 mutation.

The PCPT risk calculator provides an assessment of prostate cancer risk based on age, PSA level, race, previous biopsy, and family history. PCPT risk scores are determined for all PRAP participants. This study reports on a comparison between PCPT risk scores and subsequently observed rates of diagnosis of prostate cancer. The results of the study showed the following among the 624 participants who were evaluated:

  • 382/624 (61.2 percent) were African Americans.
  • 242/624 (38.7 percent) were men with a family history of prostate cancer.
  • The median patient age was 49.0 years (with a range from 34.0 to 69.0 years).
  • The median PSA level was 0.9 ng/ml (range, 0.1-27.2 ng/ml).
  • The median baseline PCPT risk score in patients diagnosed with prostate cancer was 31.3 percent.
  • The median baseline PCPT risk score in patients in patients not diagnosed with prostate cancer was 14.2 percent.
  • The median PCPT risk score in patients diagnosed with a Gleason score ≥ 7 was 36.2 percent
  • The median PCPT risk score in all other participants was 15.2 percent.

It is clear from these data that the PCPT risk calculator score correlates with and can stratify prostate cancer risk in a cohort of younger, high-risk men with a low baseline PSA level. It is particularly important to note that the results substantiate the value of the PCPT risk calculator for younger males of African American ethnicity.

2 Responses

  1. Dear ladies and gentlemen,

    Two weeks ago I underwent a radical prosatectomy.
    Histology / Classification: Adenocarcinoma, pT3b pN1 (1/19) M0 L0 Pn1 Gleason score 4 + 3 = 7 R0.

    Your recommendation for further treatment? If radiation: with photons or protons? Is there an advantage of latter?

    Thank you very much

    Yours sincerely

    Dr. Franz Olbertz, MD

  2. Dear Dr. Olbertz:

    If you join our social network, you will be able to get input from many patients who have already been where you are today and get their invidual views on your situation.

    As a general comment, I would say that before you make the decision to have or not to have adjuvant radiation therapy, you may want to wait until (a) you have fully recovered continence and (perhaps) erectile function post-surgery and (b) you know the results of at least your first post-surgical PSA test. The relative values of immediate adjuvant as opposed to salvage radiation therapy for a man with your clinical charactistics are currently controversial even within the prostate cancer radiation oncology community.

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