| Abstrakt: |
Objective: To investigate whether a risk score for prostate cancer (PCa) lifetime risk can be used to optimise triaging of patients with a negative prostate biopsy, but under sustained suspicion of PCa. Patients and Methods: In this prospective clinical study, we included, and risk scored patients who had a PCa‐negative transrectal ultrasonography (TRUS)‐guided prostate biopsy, but elevated prostate‐specific antigen (PSA), a suspicious prostate digital rectal examination and/or a positive family history (FH) of PCa. The risk score estimated individual lifetime risk of PCa, based on a polygenic risk score (33 single nucleotide polymorphisms), age, and FH of PCa. Patients were followed, under urological supervision, for up to 4 years with annual controls, always including PSA measurements. Multiparametric magnetic resonance imaging (mpMRI) and/or prostate biopsy was performed at selected annual controls depending on risk score and at the urologist's/patient's discretion, which means that the follow‐up differed based on the risk score. Results: We included 429 patients. After risk scoring, 376/429 (88%) patients were allocated to a normal‐risk group (<30% PCa lifetime risk) and 53/429 (12%) to a high‐risk group (≥30% PCa lifetime risk). The high‐risk group had significantly different follow‐up, with more biopsy and mpMRI sessions compared to the normal‐risk group. PCa was detected in 89/429 (21%) patients, with 67/376 (18%) patients diagnosed in the normal‐risk group and 22/53 (42%) in the high‐risk group. There was no statistically significant difference in the cumulative incidence of PCa between the normal‐risk group and the high‐risk group after 4 years of follow‐up. Currently, 67/429 (16%) patients are still being followed in this ongoing study. Conclusion: In a 4‐year perspective, our PCa lifetime risk score did not demonstrate significant prognostic value for triaging patients, with a negative TRUS‐guided biopsy and sustained suspicion of PCa. [ABSTRACT FROM AUTHOR] |
