Age-Adjusted PSA Levels in @entity263 Prediction: Updated Results of the Tyrol XXXX Early Detection Program.

@entity1 @entity263 @entity5 @entity4623
OBJECTIVE: To reduce the number of unnecessary biopsies in @entity1 with @entity4623 , however, without missing significant @entity263 the present study re-evaluates the age-dependent PSA cut-offs in the Tyrol @entity263 ( @entity263 ) early detection program. @entity1 AND METHODS: The study population included 2225 @entity1 who underwent prostate biopsy due to elevated PSA levels at our department. We divided our @entity1 collective into four age groups:  <=49 years (n = 178), 50-59 years (n = 597), 60-69 years (n = 962) and >= 70 years (n = 488). We simulated different scenarios for PSA cut-off values between 1.25 and 6 ng/mL and fPSA% between 15 and 21% for all four age groups and calculated sensitivity, specificity, confidence intervals and predictive values. RESULTS: @entity263 was detected in 1218 @entity1 (54.7%). We found that in combination with free PSA  <=21% the following PSA cut-offs had the @entity5 specificity: 1.75 ng/ml for @entity1  <=49 years and 50-59 years, 2.25 ng/ml for @entity1 aged 60-69 years and 3.25 ng/ml for @entity1 >= 70 years. Using these adjusted PSA cut-off values all significant @entity5 are recognized in all age groups, yet the number of biopsies is reduced. Overall, one biopsy is avoided in 13 to 14 @entity1 (number needed to screen = 13.3, reduction of biopsies = 7.5%) when decision regarding biopsy is done according to the "new" cut-off values instead of the "old" ones. For the different age groups the number needed to screen to avoid one biopsy varied between 9.2 ( <=49 years) and 17.4 (50-59 years). CONCLUSION: With "new", fine-tuned PSA cut-offs we detect all relevant @entity263 with a significant reduction of biopsies compared to the "old" cut-off values. Optimization of age-specific PSA cut-offs is one step towards a smarter strategy in the Tyrol @entity263 Early Detection Program.
