Selective detection of histologically aggressive prostate cancer: An Early Detection Research Network Prediction model to reduce unnecessary prostate biopsies with validation in the Prostate Cancer Prevention Trial

Stephen Williams, Simpa Salami, Meredith M. Regan, Donna P. Ankerst, John T. Wei, Mark A. Rubin, Ian M. Thompson, Martin G. Sanda

Research output: Contribution to journalArticle

19 Scopus citations


BACKGROUND: Limited survival benefit and excess treatment because of prostate-specific antigen (PSA) screening in randomized trials suggests a need for more restricted selection of prostate biopsy candidates by discerning risk of histologically aggressive versus indolent cancer before biopsy. METHODS: Subjects undergoing first prostate biopsy enrolled in a multicenter, prospective cohort of the National Cancer Institute Early Detection Research Network (N = 635) were analyzed to develop a model for predicting histologically aggressive prostate cancers. The control arm of the Prostate Cancer Prevention Trial (N = 3833) was used to validate the generalization of the predictive model. RESULTS: The Early Detection Research Network cohort was comprised of men among whom 57% had no cancer, 14% had indolent cancer, and 29% had aggressive cancer. Age, body mass index, family history of prostate cancer, abnormal digital rectal examination (DRE), and PSA density (PSAD) were associated with aggressive cancer (all P 0.1 ng/mL/cc or abnormal DRE. When PSAD is

Original languageEnglish (US)
Pages (from-to)2651-2658
Number of pages8
Issue number10
StatePublished - May 15 2012
Externally publishedYes



  • biopsy
  • clinically significant
  • indolent
  • prostate cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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