{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:42:41Z","timestamp":1760316161139,"version":"build-2065373602"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2011,10,17]],"date-time":"2011-10-17T00:00:00Z","timestamp":1318809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2012,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Limited survival benefit and excess treatment because of prostate\u2010specific 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>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 <jats:italic>P<\/jats:italic> &lt; .001). The Early Detection Research Network model outperformed PSA alone in predicting aggressive cancer (area under the curve [AUC] = 0.81 vs 0.71, <jats:italic>P<\/jats:italic> &lt; .01). Model validation in the Prostate Cancer Prevention Trial cohort accurately identified men at low (&lt;10%) risk of aggressive cancer for whom biopsy could be averted (AUC = 0.78; 95% confidence interval, 0.75\u20100.80). Under criteria from the Early Detection Research Network model, prostate biopsy can be restricted to men with PSAD &gt;0.1 ng\/mL\/cc or abnormal DRE. When PSAD is &lt;0.1 ng\/mL\/cc, family history or obesity can identify biopsy candidates.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>A predictive model incorporating age, family history, obesity, PSAD, and DRE elucidates criteria whereby \u00bc of prostate biopsies can be averted while retaining high sensitivity in detecting aggressive prostate cancer. Cancer 2011. \u00a9 2011 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.26396","type":"journal-article","created":{"date-parts":[[2011,10,17]],"date-time":"2011-10-17T16:32:46Z","timestamp":1318869166000},"page":"2651-2658","source":"Crossref","is-referenced-by-count":17,"title":["Selective detection of histologically aggressive prostate cancer"],"prefix":"10.1002","volume":"118","author":[{"given":"Stephen B.","family":"Williams","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simpa","family":"Salami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meredith M.","family":"Regan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna P.","family":"Ankerst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John T.","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A.","family":"Rubin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian M.","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin G.","family":"Sanda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,10,17]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03520310046028"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.10.062"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0810084"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0810696"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03510290050036"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000141712.79986.77"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djj072"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23502"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000091806.70171.41"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2006.08.068"},{"issue":"2","key":"e_1_2_6_12_2","first-page":"2407","article-title":"Nonpalpable stage T1c prostate cancer: prediction of insignificant disease using free\/total prostate specific antigen levels and needle biopsy findings","volume":"160","author":"Epstein JI","year":"1998","journal-title":"J Urol."},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djj131"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.10.6450"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2007.0064"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/94.13.981"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)65657-1"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)65271-8"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.04.092"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000118224.54949.78"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa074311"},{"volume-title":"Prostate\u2010Specific Antigen Best Practice Statement: 2009 Update","year":"2009","author":"Carroll P","key":"e_1_2_6_22_2"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(98)00296-9"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.10.071"},{"key":"e_1_2_6_25_2","first-page":"A100","article-title":"Cost analysis for screening, diagnosing and staging prostate cancer based on a systematic review of published studies","volume":"4","author":"Ekwueme DU","year":"2007","journal-title":"Prev Chron Dis."},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2008.03.053"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)00159-X"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2009.08.025"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19940915)74:6<1667::AID-CNCR2820740605>3.0.CO;2-2"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19941201)74:11<2991::AID-CNCR2820741116>3.0.CO;2-R"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/0090-4295(94)90179-1"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2005.06.106"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000103929.91486.29"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.26396","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.26396","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T14:36:34Z","timestamp":1760279794000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.26396"}},"subtitle":["An Early Detection Research Network Prediction model to reduce unnecessary prostate biopsies with validation in the Prostate Cancer Prevention Trial"],"short-title":[],"issued":{"date-parts":[[2011,10,17]]},"references-count":32,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2012,5,15]]}},"alternative-id":["10.1002\/cncr.26396"],"URL":"https:\/\/doi.org\/10.1002\/cncr.26396","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"type":"print","value":"0008-543X"},{"type":"electronic","value":"1097-0142"}],"subject":[],"published":{"date-parts":[[2011,10,17]]}}}