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Korean J Urol Oncol > Volume 10(3); 2012 > Article
The Korean Journal of Urological Oncology 2012;10(3): 119-123.
전립선암 위험도계산기의 임상적 함축
김대경
을지대학교 의과대학 비뇨기과학교실
Clinical Implications of Prostate Cancer Risk Calculators
Dae Kyung Kim
Department of Urology, College of Medicine, Eulji University, Daejeon, Korea
Published online: December 30, 2012.
ABSTRACT
The objective of the current review is to make a critical inspection of prostate cancer risk calculators focusing on clinical aspects. To introducethe general concept for risk calculators, the Prostate Cancer Prevention Trial (PCPT) risk calculator was chosen as an example. Recent analysis of PCPT data indicates that there is no absolute PSA value that assures that a man does not have prostate cancer. The risk lies on a continuum of PSA values. Predictive models based on statistical analysis such as PCPT risk calculator have been developed to estimate the prostate cancer risk. ROC analyses show that the PCPT risk calculator modestly improves the performance of PSA level alone. Use of prostate cancer risk calculator provides valuable individualized statistical information expressed as a percent risk of prostate cancer, which may serve as an aid to patients counseling regarding whether to do prostate biopsy or not. However, most risk calculators do not maintain initial accuracy when tested by external validation. The discrepancy may come from the difference of the characteristics of target population from the initial cohort which the specific risk calculator had been derived. Study design including biopsy schemes may also contributes to the less accuracy of the risk calculators. The predictive power of the calculators in current clinical practice may be improved by modeling statistics based on the cohort similar with the target population and incorporating additional riskfactors. (Korean J Urol Oncol 2012;10:119-123)
Key Words: Prostate cancer; Risk calculator
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