The Prostate Cancer Risk Calculators
Risk Calculator 1 the general health calculator is a starting point, looking at family history, age and any medical problems with urination.
Risk Calculator 2 the PSA risk calculator looks at the levels of prostate specific antigen in patients blood to help predict whether further investigation is required.
Risk calculator 3 and 4 the urologist risk calculator using data from DRE, TRUS and/or MRI and providing probabilities based on traditional Gleason grading or with inclusion of cribriform growth for the definition of clinically significant prostate cancer.
The option of calculating probabilities based on a definition of clinically significant prostate cancer including information on cribriform growth and intraductal carcinoma is currently available for the risk calculators without MRI information.
See table below for difference in definition of clinically significant prostate cancer
|Indolent prostate cancer|
|Gleason score 3+3||Gleason 3+4 of higher or clinical stage > T2B|
|Cribriform risk calculator 3/4||GG1 or GG2 without cribriform growth or intraductal carcinoma||GG2 with cribriform or intra ductal carcinoma or GG3 or higher|
Nowadays these risk calculators are combined into one decision tree and thus can be used for men that have not been previously biopsied but also for men that have been screened previously and had a prostate biopsy with a benign result. In addition, if available, there is an option to include the result of an MRI .
Epocrates Reference Tools For Healthcare Providers
The most useful app Ive found for day-to-day use with patients is the drug compendium Epocrates. Replacing the time-honored but heavy and cumbersome PDR, this app for smartphones contains information about drug use, dosing, sound alike medications, a list of contraindications and adverse reactions, alternatives, pharmacology, cost, and even a pictorial representation to identify many of those bags of pills patients bring to the office. Like many of the better software programs, it lists drug interactions to keep the prescriber out of trouble, notifications, and a search engine for treatment guidelines. Wed all like to think we have all this information embedded in our own gray matter but a little assist from a handy pocket app provides safety, efficiency, and increases value. The free app is sufficient for your purposes.
Jeffrey E. Kaufman, MD
Private practice, Santa Ana, CA
Unnecessary Biopsies In Low Risk Men
The proportion of low risk men who underwent unnecessary biopsies was assessed by racial group. At a threshold of 10%, assuming that men with higher scores are biopsied, 250/487 low risk men would have undergone a biopsy with PCPT and 466 with PBCG. Almost all low risk Black men are biopsied with both PCPT and PBCG . For Whites and Others, the proportion of low risk men biopsied with PCPT is much lower relative to PBCG .
At the 30% threshold, PCPT would spare most low risk men a biopsy and only subject 5% to a prostate biopsy, while 42% are still biopsied with PBCG. In Blacks, the number of low risk men biopsied substantially decreases to 25 with PCPT, but continues to remain high with PBCG at 121 . There were no White and Other men biopsied with PCPT, while 27 and 38% were biopsied using PBCG, respectively. The increase in risk scores seen in PBCG does not spare low risk men, resulting in many unnecessary biopsies performed in men with indolent or no PCa.
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Family History And Genetics
Your family history is information about any health problems that have affected your family. Families have many common factors, such as their genes, environment and lifestyle. Together, these factors can help suggest if you are more likely to get some health conditions.
Inside every cell in our body is a set of instructions called genes. These are passed down from our parents. Genes control how the body grows, works and what it looks like. If something goes wrong with one or more genes , it can sometimes cause cancer.
Is prostate cancer hereditary?
If people in your family have prostate cancer or breast cancer, it might increase your own risk of getting prostate cancer. This is because you may have inherited the same faulty genes.
My father had prostate cancer. What are my risks?
- You are two and a half times more likely to get prostate cancer if your father or brother has had it, compared to a man who has no relatives with prostate cancer.
- Your chance of getting prostate cancer may be even greater if your father or brother was under 60 when he was diagnosed, or if you have more than one close relative with prostate cancer.
- Your risk of getting prostate cancer may also be higher if your mother or sister has had breast cancer.
Do you have a family history of prostate cancer?
If you’re over 45 and your father or brother has had prostate cancer, you may want to talk to your GP. Our Specialist Nurses can also help you understand your hereditary risk of prostate cancer.
Prostate Cancer Risk Calculators
Prostate cancer risk calculators, also called nomograms, use prediction models for risk assessment or risk estimates. Doctors use prostate cancer nomograms from screening through prostatectomy, chemotherapy, and radiation.
Some were designed for patients to use. The latest version, created by researchers at Kaiser Permanente, helps patients and their doctors better understand the risk of getting prostate cancer. The goal is to have more informed decision-making regarding screenings.
Another, the SWOP prostate cancer risk calculator is actually multiple nomograms .
Available online or as an iPhone or Android app, these prostate cancer risk calculators allow patients with no medical knowledge to safely assess their risks for getting prostate cancer based on various data points.
- Prostate cancer risk calculator #2 is for patients with a recent PSA.
Disclaimer: No prostate cancer risk calculator is 100% accurate. Your results are meant to be shared with your doctor, so they will help interpret your results and possibly refer you to a urology specialist for further testing at a medical center or to a radiology center for a scan.
Note On Men Of African Descent
The calculations do not specifically apply to men of African descent because insufficient numbers were available for inclusion in the original European study to obtain meaningful data. However, as this group of men have a genetically higher risk of developing prostate cancer, you may find the information provided by Prostate Cancer UK a useful source of specific help and guidance.
This does not mean the calculators may not be useful to you if you are over 55. But caution is needed because the calculator may underestimate your risk of prostate cancer.
As part of the European Randomized Study of Screening for Prostate Cancer, PSA test results from more than 20,000 men in the Rotterdam area were assessed and monitored over a twelve-year period. From this group, 6,288 men aged 55-74 met the strict criteria for inclusion in the separate risk calculator project.
These men also had two extra diagnostic tests a rectal examination and an ultrasound to check for abnormalities and measure the volume of their prostate gland. Out of this group, 29% required additional investigations. Once these had been completed, only 6% were found to have prostate cancer .
Table showing results of this cancer detection study
Prostate Cancer Risk Calculator Uk
Semantic Scholar Department of Antiviral Therapy Human papillomavirus infection in child, Vasile Rus – Referine bibliografice Google Academic Fiziopatologia infeciei cu HPV aprute în contextul pacienilor seropozitivi pentru infecia HIV Human papillomavirus infection etiology and pathogenesis The virus infects basal epithelial cells of stratified squamous epithelium.
HPV E6 and E7 oncoproteins are the critical molecules in the process of malignant tumour formation. Human papillomavirus infection child, Interacting with various cellular human papillomavirus infection etiology and pathogenesis, E6 and E7 influence fundamental cellular functions like cell cycle regulation, prostate cancer risk calculator uk maintenance, susceptibility to apoptosis, intercellular adhesion and regulation of immune responses.
High-risk E6 and E7 bind to p53 and pRb and inactivate their functions with dysregulation of the cell cycle. Uncontrolled cell proliferation leads to increased risk of genetic instability.
Usually, it takes decades for human papillomavirus infection in child to develop. This review presents the main mechanisms human papillomavirus infection in child HPV genome in the carcinogenesis of the uterine cervix.
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Welcome To The Qcancer Risk Calculator
Welcome to the QCancer® Web Calculator. You can use this calculator to work out your risk of developing a diagnosis of prostate cancer by answering some simple questions.
The QCancer® algorithm has been developed by Julia Hippisley-Cox and Carol Coupland, and are based on routinely collected data from many thousands of GPs across the country who have freely contributed data to the QResearch database for medical research.
QCancer® has been developed for the UK population, and is intended for use in the UK. All medical decisions need to be taken by a patient in consultation with their doctor. The authors and the sponsors accept no responsibility for clinical use or misuse of this score.
The science underpinning the new QCancer® equations has been pubished in the British Journal of General Practice.
Materials on this web site are protected by copyright law. Access to the materials on this web site for the sole purpose of personal educational and research use only. Where appropriate a single print out of a reasonable proportion of these materials may be made for personal education, research and private study. Materials should not be further copied, photocopied or reproduced, or distributed in electronic form. Any unauthorised use or distribution for commercial purposes is expressly forbidden. Any other unauthorised use or distribution of the materials may constitute an infringement of ClinRisk Ltd.’s copyright and may lead to legal action.
Rotterdam Prostate Cancer Risk Calculator
The Rotterdam Prostate Cancer Risk Calculator app was released through the Prostate Cancer Research Foundation, Rotterdam, in partnership with the European Randomized Study of Screening for Prostate Cancer . The tool can be accessed as a smartphone or tablet app, available on Android or iOS , or via a series of calculators at .
The website version of the risk calculators are meant for use as a decision aid for laypeople, general practitioners and urologists2. On the website there are 6 calculators. These calculators provide an estimate of risk of sextant biopsy detectable prostate cancer based upon age, family history, and urinary complaints , PSA alone . Calculators 3-6 are designed for use by urologists and require more complex information such as DRE findings and volume, TRUS findings and volume and previous biopsy status.
The mobile application was developed to improve the user friendliness and accessibility of the calculators and combines a lot of the previous calculators into one easy to use application3. The values that the calculator uses include PSA, Previous biopsy negative, DRE examination findings, TRUS volume and TRUS findings and Phi . If the patient has not had a TRUS than volume can be estimated according to DRE findings instead.
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Number Of Avoided Biopsies And Missed Clinically Significant Prostate Cancer
Figure presents the theoretical number of biopsies avoided and missed csPCa at the 10% and30% risk thresholds.
Theoretical number of avoided biopsies and missed clinically significant cancers at the 10 and 30% predictive thresholds by race. PCPT=Prostate Cancer Prevention Trial risk calculator PBCG=Prostate Biopsy Collaborative Group risk calculator csPCa=clinically significant prostate cancer. Blue bar: Total number of biopsies avoided Red bar: Missed clinically significant prostate cancer
At the 10% threshold, assuming no biopsies are performed below this threshold, the number of biopsies avoided with the PCPT RC for All men is 336/954 compared to 28/954 with PBCG. The PCPT RC, however, missed 80 csPCas compared to 4 csPCas when using PBCG. Few Black men fall below the 10% risk threshold, so the number of avoided biopsies is small with both calculators. The difference is particularly prominent in Whites where the percentage of biopsies avoided is ten-fold higher with PCPT relative to PBCG .
At the 30% threshold in All men, 748 biopsies are avoided using PCPT compared to 376 with PBCG, and the number of missed csPCa is 207 and 85 , respectively. Black and Other men demonstrate a similar trend, where more than twice as many biopsies are avoided using PCPT with similar rates of missed csPCa .
Evidence Based On Worlds Largest Prostate Cancer Screening Study
Aged 55-74, these were men from Rotterdam in The Netherlands, already taking part in the European Randomized Study of Screening for Prostate Cancer. The ERSPC is the worlds largest study to find out whether the early detection of cancer by means of prostate specific antigen testing could save lives. The Prostate Cancer Risk Calculator applies to men aged 55-74. Younger men have a much lower chance of being diagnosed with prostate cancer and this age group was therefore not included in the ERSPC study on which the data has been based.
For further information: Prostate Cancer Risk Calculator verification data and ERSPC published findings
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A Calculator For Prostate Cancer Risk 4 Years After An Initially Negative Screen: Findings From Erspc Rotterdam Beyond The Abstract By Xiaoye Zhu Md And Monique J Roobol Phd Msc
BERKELEY, CA PSA screening reduces prostate cancer mortality. Therefore, general practitioners and urologists are increasingly confronted with requests for PSA testing.However, there are several substantial harms as a result of screening, such as unnecessary biopsies and over-diagnosis. Furthermore, there is uncertainty surrounding the follow-up of men who were screened negatively for prostate cancer. When the screening test or the prostate biopsy is negative, physicians often struggle with questions regarding if and how to continue testing.
To provide support in these difficult decision points, we have developed the future-risk calculator, based on data from 15 791 screen-negative men at the initial screening round from the Rotterdam branch of the ERPSC trial. This calculator is readily available on our website: www.prostatecancer-riskcalculator.com. It was based on initial screening data on age, PSA, digital rectal examination, family history, prostate volume, and information on previous biopsy. The outcome was the 4-year risk of biopsy-detectable prostate cancer, which was a priori categorized as no cancer, cancer with a low risk of progression, and cancer with a potentially high risk of progression. The 4-year predictions were validated with additional follow-up data up to 8 years after initial screening.
Figure 1A: 4-year future risk of a 65-year-old man, PSA 2.5 ng/ml, normal DRE, no family history, prostate volume class of 40 cm3, and no previous biopsy.
Prostate Cancer Prevention Trial Risk Calculator Version 20
The original Prostate Cancer Prevention Trial Prostate Cancer Risk Calculator posted in 2006 was developed based upon 5519 men in the placebo group of the Prostate Cancer Prevention Trial. All of these 5519 men initially had a prostate-specific antigen value less than or equal to 3.0 ng/ml and were followed for seven years with annual PSA and digital rectal examination . If PSA exceeded 4.0 ng/ml or if an abnormal DRE was noted, a biopsy was recommended. After seven years, all men were recommended to have a prostate biopsy, regardless of PSA or DRE findings. PSA, family history, DRE findings, and history of a prior negative prostate biopsy provided independent predictive value to the calculation of risk of a biopsy that showed presence of cancer.
The results of the PCPTRC may not apply to different groups of individuals. As about 80% of men had a prostate biopsy with six cores, if more than six cores are obtained at biopsy, a greater risk of cancer may be expected. Most men in this study were white and results may be different with other ethnicities or races. The calculator is in principle only applicable to men under the following restrictions:
- Age 55 or older
- No previous diagnosis of prostate cancer
- DRE and PSA results less than 1 year old
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Symptoms Of Prostate Cancer
When this happens, you may notice things like:
- an increased need to pee
- straining while you pee
- a feeling that your bladder has not fully emptied
These symptoms should not be ignored, but they do not mean you have prostate cancer.
It’s more likely they’re caused by something else, such as prostate enlargement.
Who Is At Risk For Prostate Cancer
All men are at risk for prostate cancer, but African-American men are more likely to get prostate cancer than other men.
All men are at risk for prostate cancer. Out of every 100 American men, about 13 will get prostate cancer during their lifetime, and about 2 to 3 men will die from prostate cancer.
The most common risk factor is age. The older a man is, the greater the chance of getting prostate cancer.
Some men are at increased risk for prostate cancer. You are at increased risk for getting or dying from prostate cancer if you are African-American or have a family history of prostate cancer.
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How Do I Use Predict Prostate
Enter the details about yourself and your prostate cancer, and then select conservative management or radical treatment to see estimates of survival with each.
We recommend patients read theAbout Predict section before using the tool. Predict Prostate is only intended for use amongst men for whom both conservative management and radical treatment could both be appropriate options
Information About Calculator Input
Prostate Specific Antigen Level
This is the result, in nanograms per mililiter, of the PSA blood test. PSA has to be between 2 and 50 .
Family History of Prostate Cancer
Choose Yes if a father, brother, or son had prostate cancer.
Digital Rectal Examination
Digital Rectal Examination is a test performed by a health care professional in which a gloved finger is placed in the rectum to feel the surface of the prostate. It is normal if the prostate is smooth and soft. It is abnormal if an area of firmness or a nodule is noted.
Prior Prostate Biopsy
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