Recommended Definitions of Aggressive Prostate Cancer for Etiologic Epidemiologic Research.


Journal

Journal of the National Cancer Institute
ISSN: 1460-2105
Titre abrégé: J Natl Cancer Inst
Pays: United States
ID NLM: 7503089

Informations de publication

Date de publication:
01 06 2021
Historique:
received: 05 06 2020
revised: 07 08 2020
accepted: 15 09 2020
pubmed: 4 10 2020
medline: 25 2 2022
entrez: 3 10 2020
Statut: ppublish

Résumé

In the era of widespread prostate-specific antigen testing, it is important to focus etiologic research on the outcome of aggressive prostate cancer, but studies have defined this outcome differently. We aimed to develop an evidence-based consensus definition of aggressive prostate cancer using clinical features at diagnosis for etiologic epidemiologic research. Among prostate cancer cases diagnosed in 2007 in the National Cancer Institute's Surveillance, Epidemiology, and End Results-18 database with follow-up through 2017, we compared the performance of categorizations of aggressive prostate cancer in discriminating fatal prostate cancer within 10 years of diagnosis, placing the most emphasis on sensitivity and positive predictive value (PPV). In our case population (n = 55 900), 3073 men died of prostate cancer within 10 years. Among 12 definitions that included TNM staging and Gleason score, sensitivities ranged from 0.64 to 0.89 and PPVs ranged from 0.09 to 0.23. We propose defining aggressive prostate cancer as diagnosis of category T4 or N1 or M1 or Gleason score of 8 or greater prostate cancer, because this definition had one of the higher PPVs (0.23, 95% confidence interval = 0.22 to 0.24) and reasonable sensitivity (0.66, 95% confidence interval = 0.64 to 0.67) for prostate cancer death within 10 years. Results were similar across sensitivity analyses. We recommend that etiologic epidemiologic studies of prostate cancer report results for this definition of aggressive prostate cancer. We also recommend that studies separately report results for advanced category (T4 or N1 or M1), high-grade (Gleason score ≥8), and fatal prostate cancer. Use of this comprehensive set of endpoints will facilitate comparison of results from different studies and help elucidate prostate cancer etiology.

Sections du résumé

BACKGROUND
In the era of widespread prostate-specific antigen testing, it is important to focus etiologic research on the outcome of aggressive prostate cancer, but studies have defined this outcome differently. We aimed to develop an evidence-based consensus definition of aggressive prostate cancer using clinical features at diagnosis for etiologic epidemiologic research.
METHODS
Among prostate cancer cases diagnosed in 2007 in the National Cancer Institute's Surveillance, Epidemiology, and End Results-18 database with follow-up through 2017, we compared the performance of categorizations of aggressive prostate cancer in discriminating fatal prostate cancer within 10 years of diagnosis, placing the most emphasis on sensitivity and positive predictive value (PPV).
RESULTS
In our case population (n = 55 900), 3073 men died of prostate cancer within 10 years. Among 12 definitions that included TNM staging and Gleason score, sensitivities ranged from 0.64 to 0.89 and PPVs ranged from 0.09 to 0.23. We propose defining aggressive prostate cancer as diagnosis of category T4 or N1 or M1 or Gleason score of 8 or greater prostate cancer, because this definition had one of the higher PPVs (0.23, 95% confidence interval = 0.22 to 0.24) and reasonable sensitivity (0.66, 95% confidence interval = 0.64 to 0.67) for prostate cancer death within 10 years. Results were similar across sensitivity analyses.
CONCLUSIONS
We recommend that etiologic epidemiologic studies of prostate cancer report results for this definition of aggressive prostate cancer. We also recommend that studies separately report results for advanced category (T4 or N1 or M1), high-grade (Gleason score ≥8), and fatal prostate cancer. Use of this comprehensive set of endpoints will facilitate comparison of results from different studies and help elucidate prostate cancer etiology.

Identifiants

pubmed: 33010161
pii: 5917632
doi: 10.1093/jnci/djaa154
pmc: PMC8248961
doi:

Substances chimiques

Prostate-Specific Antigen EC 3.4.21.77

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

727-734

Subventions

Organisme : NCI NIH HHS
ID : P30 CA006973
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA182883
Pays : United States
Organisme : NCI NIH HHS
ID : K07 CA230182
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NCI NIH HHS
ID : UM1 CA167462
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA006516
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA167552
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA063673
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA167462
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA164975
Pays : United States

Commentaires et corrections

Type : ErratumIn

Informations de copyright

Published by Oxford University Press 2020.

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Auteurs

Lauren M Hurwitz (LM)

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.

Ilir Agalliu (I)

Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.

Demetrius Albanes (D)

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.

Kathryn Hughes Barry (KH)

Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
Program in Oncology, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA.

Sonja I Berndt (SI)

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.

Qiuyin Cai (Q)

Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA.

Chu Chen (C)

Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

Iona Cheng (I)

Department of Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.

Jeanine M Genkinger (JM)

Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.

Graham G Giles (GG)

Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.
Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia.
Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.

Jiaqi Huang (J)

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.

Corinne E Joshu (CE)

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Tim J Key (TJ)

Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.

Synnove Knutsen (S)

School of Public Health, Loma Linda University, Loma Linda, CA, USA.

Stella Koutros (S)

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.

Hilde Langseth (H)

Department of Research, Cancer Registry of Norway, Oslo, Norway.
Department of Epidemiology and Biostatistics, Imperial College London, London, UK.

Sherly X Li (SX)

Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.
Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia.
Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK.

Robert J MacInnis (RJ)

Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.
Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia.

Sarah C Markt (SC)

Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA.

Kathryn L Penney (KL)

Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Aurora Perez-Cornago (A)

Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.

Thomas E Rohan (TE)

Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.

Stephanie A Smith-Warner (SA)

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Meir J Stampfer (MJ)

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Konrad H Stopsack (KH)

Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Catherine M Tangen (CM)

SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

Ruth C Travis (RC)

Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.

Stephanie J Weinstein (SJ)

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.

Wu Lang PhD (W)

Cancer Epidemiology Division, Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA.

Eric J Jacobs (EJ)

Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA, USA.

Lorelei A Mucci (LA)

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Elizabeth A Platz (EA)

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Michael B Cook (MB)

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.

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