Association of Urinary MyProstateScore, Age, and Prostate Volume in a Longitudinal Cohort of Healthy Men: Long-term Findings from the Olmsted County Study

Jeffrey J. Tosoian; Rodney L. Dunn; Yashar S. Niknafs; Anjan Saha; Randy A. Vince, Jr; Jennifer L. St. Sauver; Debra J. Jacobson; Michaela E. McGree; Javed Siddiqui; Jack Groskopf; Steven J. Jacobsen; Scott A. Tomlins; Lakshmi P. Kunju; Todd M. Morgan; Simpa S. Salami; John T. Wei; Arul M. Chinnaiyan; Aruna V. Sarma

European Urology Open Science (Jul 2021)

Association of Urinary MyProstateScore, Age, and Prostate Volume in a Longitudinal Cohort of Healthy Men: Long-term Findings from the Olmsted County Study

Jeffrey J. Tosoian,
Rodney L. Dunn,
Yashar S. Niknafs,
Anjan Saha,
Randy A. Vince, Jr,
Jennifer L. St. Sauver,
Debra J. Jacobson,
Michaela E. McGree,
Javed Siddiqui,
Jack Groskopf,
Steven J. Jacobsen,
Scott A. Tomlins,
Lakshmi P. Kunju,
Todd M. Morgan,
Simpa S. Salami,
John T. Wei,
Arul M. Chinnaiyan,
Aruna V. Sarma

Affiliations

Jeffrey J. Tosoian: Department of Urology, University of Michigan, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA; Corresponding author. Department of Urology, The University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA. Tel. +1 734 6156662; Fax: +1 734 6479480.
Rodney L. Dunn: Department of Urology, University of Michigan, Ann Arbor, MI, USA
Yashar S. Niknafs: Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
Anjan Saha: Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
Randy A. Vince, Jr: Department of Urology, University of Michigan, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
Jennifer L. St. Sauver: Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
Debra J. Jacobson: Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
Michaela E. McGree: Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
Javed Siddiqui: Department of Urology, University of Michigan, Ann Arbor, MI, USA; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
Jack Groskopf: MDxHealth Inc., Irvine, CA, USA
Steven J. Jacobsen: Department of Research and Evaluation, Kaiser Permanente of Southern California, Pasadena, CA, USA
Scott A. Tomlins: Department of Urology, University of Michigan, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
Lakshmi P. Kunju: Department of Urology, University of Michigan, Ann Arbor, MI, USA; Department of Pathology, University of Michigan, Ann Arbor, MI, USA
Todd M. Morgan: Department of Urology, University of Michigan, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
Simpa S. Salami: Department of Urology, University of Michigan, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
John T. Wei: Department of Urology, University of Michigan, Ann Arbor, MI, USA
Arul M. Chinnaiyan: Department of Urology, University of Michigan, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA; Department of Pathology, University of Michigan, Ann Arbor, MI, USA; Howard Hughes Medical Institute, University of Michigan, Ann Arbor, MI, USA
Aruna V. Sarma: Department of Urology, University of Michigan, Ann Arbor, MI, USA; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA

Journal volume & issue: Vol. 29
pp. 30 – 35

Abstract

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Background: Serum prostate-specific antigen (PSA), used in prostate cancer screening, is nonspecific for cancer and is affected by age and prostate volume. More specific biomarkers could be more accurate for early detection of prostate cancer and reduce unnecessary prostate biopsies. Objective: To evaluate the association of age and prostate volume with urinary MyProstateScore (MPS) in a screened, longitudinal cohort without evidence of prostate cancer. Design, setting, and participants: The Olmsted County Study included men aged 40–79 yr who underwent biennial prostate cancer screening. PSA ≥4.0 ng/ml or abnormal rectal examination triggered prostate biopsy, and patients with cancer were excluded. The remaining men submitted urinary specimens for PCA3 and TMPRSS2:ERG testing. Outcome measurements and statistical analysis: MPS was calculated using the validated, locked model for grade group ≥2 cancer that includes serum PSA, urinary PCA3, and urinary TMPRSS2:ERG. The associations of age and volume with biomarkers were assessed in multivariable regression models. The t statistic was used to quantify the strength of associations independent of the unit of measurement, and R2 values were used to estimate the proportion of biomarker variance explained by each factor. Results and limitations: The study included 314 screened men without evidence of cancer. In multivariable models including age and volume, PCA3 score was significantly associated with age (t = 7.51; p < 0.001), while T2:ERG score was not associated with age or volume. MPS was significantly associated with both age (t = 7.45; p < 0.001) and volume (t = 3.56; p < 0.001), but accounting for age alone explained the variability observed (R2 = 0.29) in a similar way to the model including age and volume (R2 = 0.31). The variability of PCA3, T2:ERG, and MPS was less dependent on age and volume than the variability for PSA (R2 = 0.45). Conclusions: In a cohort of longitudinally screened men without evidence of cancer, we found that MPS demonstrated less variability with noncancer factors (age, prostate volume) than PSA did. These findings support the biology of these markers as more cancer-specific than PSA and highlight their promise in reducing the morbidity associated with PSA-based screening. Patient summary: In a group of men with no evidence of prostate cancer, we found that each of three urine-based markers of cancer—PCA3, T2:ERG, and the commercially available MyProstateScore test—showed less variability with noncancer factors (age and prostate volume) than serum PSA (prostate-specific antigen) did. These findings support their proposed use as noninvasive markers of prostate cancer that could improve the accuracy of early detection.

Published in European Urology Open Science

ISSN: 2666-1683 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the genitourinary system. Urology; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.journals.elsevier.com/european-urology-open-science

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