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Smith K, Byrne, Castaño JM, Chirlaque MD, Lilja H, Agudo A, Ardanaz E, Rodríguez-Barranco M, Boeing H, Kaaks R, Khaw KT, Larrañaga N, Navarro C, Olsen A, Overvad K, Perez-Cornago A, Rohrmann S, Sánchez MJ, Tjønneland A, Tsilidis KK, Johansson M, Riboli E, Key TJ, Travis RC. Vasectomy and Prostate Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC). J Clin Oncol 2017; 35:1297-1303. [PMID: 28375714 PMCID: PMC5455458 DOI: 10.1200/jco.2016.70.0062] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose Vasectomy is a commonly used form of male sterilization, and some studies have suggested that it may be associated with an increased risk of prostate cancer, including more aggressive forms of the disease. We investigated the prospective association of vasectomy with prostate cancer in a large European cohort, with a focus on high-grade and advanced-stage tumors, and death due to prostate cancer. Patients and Methods A total of 84,753 men from the European Prospective Investigation into Cancer and Nutrition (EPIC), aged 35 to 79 years, provided information on vasectomy status (15% with vasectomy) at recruitment and were followed for incidence of prostate cancer and death. We estimated the association of vasectomy with prostate cancer risk overall, by tumor subtype, and for death due to prostate cancer, using multivariable-adjusted Cox proportional hazards models. Results During an average follow-up of 15.4 years, 4,377 men were diagnosed with prostate cancer, including 641 who had undergone a vasectomy. Vasectomy was not associated with prostate cancer risk (hazard ratio [HR], 1.05; 95% CI, 0.96 to 1.15), and no evidence for heterogeneity in the association was observed by stage of disease or years since vasectomy. There was some evidence of heterogeneity by tumor grade ( P = .02), with an increased risk for low-intermediate grade (HR, 1.14; 95% CI, 1.01 to 1.29) but not high-grade prostate cancer (HR, 0.83; 95% CI, 0.64 to 1.07). Vasectomy was not associated with death due to prostate cancer (HR, 0.88; 95% CI, 0.68 to 1.12). Conclusion These findings from a large European prospective study show no elevated risk for overall, high-grade or advanced-stage prostate cancer, or death due to prostate cancer in men who have undergone a vasectomy compared with men who have not.
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Affiliation(s)
- Karl Smith
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Byrne
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Jose Maria Castaño
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Maria Dolores Chirlaque
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Hans Lilja
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Antonio Agudo
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Eva Ardanaz
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Miguel Rodríguez-Barranco
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Heiner Boeing
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Rudolf Kaaks
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Kay-Tee Khaw
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Nerea Larrañaga
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Carmen Navarro
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Anja Olsen
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Kim Overvad
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Aurora Perez-Cornago
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Sabine Rohrmann
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Maria José Sánchez
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Anne Tjønneland
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Konstantinos K. Tsilidis
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Mattias Johansson
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Elio Riboli
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Timothy J. Key
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
| | - Ruth C. Travis
- Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France
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Bryant RJ, Sjoberg DD, Vickers AJ, Robinson MC, Kumar R, Marsden L, Davis M, Scardino PT, Donovan J, Neal DE, Lilja H, Hamdy FC. Predicting high-grade cancer at ten-core prostate biopsy using four kallikrein markers measured in blood in the ProtecT study. J Natl Cancer Inst 2015; 107:djv095. [PMID: 25863334 PMCID: PMC4554254 DOI: 10.1093/jnci/djv095] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Many men with elevated prostate-specific antigen (PSA) levels in serum do not have aggressive prostate cancer and undergo unnecessary biopsy. Retrospective studies using cryopreserved serum suggest that four kallikrein markers can predict biopsy outcome. Methods: Free, intact and total PSA, and kallikrein-related peptidase 2 were measured in cryopreserved blood from 6129 men with elevated PSA (≥3.0ng/mL) participating in the prospective, randomized trial Prostate Testing for Cancer and Treatment. Marker levels from 4765 men providing anticoagulated plasma were incorporated into statistical models to predict any-grade and high-grade (Gleason score ≥7) prostate cancer at 10-core biopsy. The models were corrected for optimism by 10-fold cross validation and independently validated using markers measured in serum from 1364 men. All statistical tests were two-sided. Results: The four kallikreins enhanced prostate cancer detection compared with PSA and age alone. Area under the curve (AUC) for the four kallikreins was 0.719 (95% confidence interval [CI] = 0.704 to 0.734) vs 0.634 (95% CI = 0.617 to 0.651, P < .001) for PSA and age alone for any-grade cancer, and 0.820 (95% CI = 0.802 to 0.838) vs 0.738 (95% CI = 0.716 to 0.761) for high-grade cancer. Using a 6% risk of high-grade cancer as an illustrative cutoff, for 1000 biopsied men with PSA levels of 3.0ng/mL or higher, the model would reduce the need for biopsy in 428 men, detect 119 high-grade cancers, and delay diagnosis of 14 of 133 high-grade cancers. Models exhibited excellent discrimination on independent validation among men with only serum samples available for analysis. Conclusions: A statistical model based on kallikrein markers was validated in a large prospective study and reduces unnecessary biopsies while delaying diagnosis of high-grade cancers in few men.
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Affiliation(s)
- Richard J Bryant
- Nuffield Department of Surgical Sciences, University of Oxford, UK (RJB, RK, LM, HL, FCH); Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY (DDS, AJV); Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK (MCR); School of Social and Community Medicine, University of Bristol, UK (MD); Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center (PTS, HL); Department of Oncology, University of Cambridge, UK (DEN); Departments of Laboratory Medicine (Clinical Chemistry Service) and Medicine (Genitourinary Oncology Service), Memorial Sloan Kettering Cancer Center, New York, NY (HL); Department of Laboratory Medicine and Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden; and Institute of Biomedical Technology, University of Tampere, Finland (HL)
| | - Daniel D Sjoberg
- Nuffield Department of Surgical Sciences, University of Oxford, UK (RJB, RK, LM, HL, FCH); Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY (DDS, AJV); Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK (MCR); School of Social and Community Medicine, University of Bristol, UK (MD); Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center (PTS, HL); Department of Oncology, University of Cambridge, UK (DEN); Departments of Laboratory Medicine (Clinical Chemistry Service) and Medicine (Genitourinary Oncology Service), Memorial Sloan Kettering Cancer Center, New York, NY (HL); Department of Laboratory Medicine and Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden; and Institute of Biomedical Technology, University of Tampere, Finland (HL)
| | - Andrew J Vickers
- Nuffield Department of Surgical Sciences, University of Oxford, UK (RJB, RK, LM, HL, FCH); Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY (DDS, AJV); Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK (MCR); School of Social and Community Medicine, University of Bristol, UK (MD); Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center (PTS, HL); Department of Oncology, University of Cambridge, UK (DEN); Departments of Laboratory Medicine (Clinical Chemistry Service) and Medicine (Genitourinary Oncology Service), Memorial Sloan Kettering Cancer Center, New York, NY (HL); Department of Laboratory Medicine and Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden; and Institute of Biomedical Technology, University of Tampere, Finland (HL)
| | - Mary C Robinson
- Nuffield Department of Surgical Sciences, University of Oxford, UK (RJB, RK, LM, HL, FCH); Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY (DDS, AJV); Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK (MCR); School of Social and Community Medicine, University of Bristol, UK (MD); Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center (PTS, HL); Department of Oncology, University of Cambridge, UK (DEN); Departments of Laboratory Medicine (Clinical Chemistry Service) and Medicine (Genitourinary Oncology Service), Memorial Sloan Kettering Cancer Center, New York, NY (HL); Department of Laboratory Medicine and Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden; and Institute of Biomedical Technology, University of Tampere, Finland (HL)
| | - Rajeev Kumar
- Nuffield Department of Surgical Sciences, University of Oxford, UK (RJB, RK, LM, HL, FCH); Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY (DDS, AJV); Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK (MCR); School of Social and Community Medicine, University of Bristol, UK (MD); Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center (PTS, HL); Department of Oncology, University of Cambridge, UK (DEN); Departments of Laboratory Medicine (Clinical Chemistry Service) and Medicine (Genitourinary Oncology Service), Memorial Sloan Kettering Cancer Center, New York, NY (HL); Department of Laboratory Medicine and Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden; and Institute of Biomedical Technology, University of Tampere, Finland (HL)
| | - Luke Marsden
- Nuffield Department of Surgical Sciences, University of Oxford, UK (RJB, RK, LM, HL, FCH); Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY (DDS, AJV); Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK (MCR); School of Social and Community Medicine, University of Bristol, UK (MD); Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center (PTS, HL); Department of Oncology, University of Cambridge, UK (DEN); Departments of Laboratory Medicine (Clinical Chemistry Service) and Medicine (Genitourinary Oncology Service), Memorial Sloan Kettering Cancer Center, New York, NY (HL); Department of Laboratory Medicine and Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden; and Institute of Biomedical Technology, University of Tampere, Finland (HL)
| | - Michael Davis
- Nuffield Department of Surgical Sciences, University of Oxford, UK (RJB, RK, LM, HL, FCH); Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY (DDS, AJV); Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK (MCR); School of Social and Community Medicine, University of Bristol, UK (MD); Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center (PTS, HL); Department of Oncology, University of Cambridge, UK (DEN); Departments of Laboratory Medicine (Clinical Chemistry Service) and Medicine (Genitourinary Oncology Service), Memorial Sloan Kettering Cancer Center, New York, NY (HL); Department of Laboratory Medicine and Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden; and Institute of Biomedical Technology, University of Tampere, Finland (HL)
| | - Peter T Scardino
- Nuffield Department of Surgical Sciences, University of Oxford, UK (RJB, RK, LM, HL, FCH); Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY (DDS, AJV); Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK (MCR); School of Social and Community Medicine, University of Bristol, UK (MD); Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center (PTS, HL); Department of Oncology, University of Cambridge, UK (DEN); Departments of Laboratory Medicine (Clinical Chemistry Service) and Medicine (Genitourinary Oncology Service), Memorial Sloan Kettering Cancer Center, New York, NY (HL); Department of Laboratory Medicine and Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden; and Institute of Biomedical Technology, University of Tampere, Finland (HL)
| | - Jenny Donovan
- Nuffield Department of Surgical Sciences, University of Oxford, UK (RJB, RK, LM, HL, FCH); Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY (DDS, AJV); Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK (MCR); School of Social and Community Medicine, University of Bristol, UK (MD); Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center (PTS, HL); Department of Oncology, University of Cambridge, UK (DEN); Departments of Laboratory Medicine (Clinical Chemistry Service) and Medicine (Genitourinary Oncology Service), Memorial Sloan Kettering Cancer Center, New York, NY (HL); Department of Laboratory Medicine and Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden; and Institute of Biomedical Technology, University of Tampere, Finland (HL)
| | - David E Neal
- Nuffield Department of Surgical Sciences, University of Oxford, UK (RJB, RK, LM, HL, FCH); Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY (DDS, AJV); Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK (MCR); School of Social and Community Medicine, University of Bristol, UK (MD); Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center (PTS, HL); Department of Oncology, University of Cambridge, UK (DEN); Departments of Laboratory Medicine (Clinical Chemistry Service) and Medicine (Genitourinary Oncology Service), Memorial Sloan Kettering Cancer Center, New York, NY (HL); Department of Laboratory Medicine and Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden; and Institute of Biomedical Technology, University of Tampere, Finland (HL)
| | - Hans Lilja
- Nuffield Department of Surgical Sciences, University of Oxford, UK (RJB, RK, LM, HL, FCH); Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY (DDS, AJV); Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK (MCR); School of Social and Community Medicine, University of Bristol, UK (MD); Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center (PTS, HL); Department of Oncology, University of Cambridge, UK (DEN); Departments of Laboratory Medicine (Clinical Chemistry Service) and Medicine (Genitourinary Oncology Service), Memorial Sloan Kettering Cancer Center, New York, NY (HL); Department of Laboratory Medicine and Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden; and Institute of Biomedical Technology, University of Tampere, Finland (HL).
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, UK (RJB, RK, LM, HL, FCH); Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY (DDS, AJV); Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK (MCR); School of Social and Community Medicine, University of Bristol, UK (MD); Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center (PTS, HL); Department of Oncology, University of Cambridge, UK (DEN); Departments of Laboratory Medicine (Clinical Chemistry Service) and Medicine (Genitourinary Oncology Service), Memorial Sloan Kettering Cancer Center, New York, NY (HL); Department of Laboratory Medicine and Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden; and Institute of Biomedical Technology, University of Tampere, Finland (HL)
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