J Urol. 2012 Dec 13. pii: S0022-5347(12)05850-8. doi: 10.1016/j.juro.2012.12.023. [Epub ahead of print]
Personalized PSA Testing Using Genetic Variants May Reduce Unnecessary Prostate Biopsies.
SourceDivision of Urology, Northshore University Healthcare System, Evanston, IL.
PURPOSE:Recent studies have identified genetic variants associated with both increased serum PSA concentrations and prostate cancer risk, raising the possibility of diagnostic bias. By correcting for the effects of these variants on PSA levels, it may be possible to create a personalized PSA cutoff to more accurately identify individuals for whom biopsy is recommended. We therefore determined how many men would continue to meet common biopsy criteria after genetic correction of their measured PSA concentrations.
MATERIALS AND METHODS:The genotypes of 4 single nucleotide polymorphisms (SNPs) previously associated with serum PSA levels (rs2736098, rs10788160, rs11067228, and rs17632542) were determined in 964 healthy Caucasian volunteers without prostate cancer. Genetic correction of the PSA was performed by dividing an individual's PSA value by his combined genetic risk. Analyses were used to compare the percentage of men that would meet commonly used biopsy thresholds (≥2.5 or ≥4.0 ng/mL) before and after genetic correction.
RESULTS:Genetic correction of serum PSA results was associated with a significantly decreased frequency of men meeting biopsy thresholds. Genetic correction could lead to a 15% and 20% relative reduction in the total number of biopsies using a biopsy threshold of ≥2.5 or ≥4.0 ng/mL, respectively. In addition, genetic correction could result in an 18-22% reduction in the number of potentially unnecessary biopsies and a 3% decrease in potentially delayed diagnoses.
CONCLUSIONS:Our results suggest that 4 SNPs can be used to adjust a man's measured PSA concentration and potentially delay or prevent unnecessary prostate biopsies in Caucasian men.
Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
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