Implementing European Randomised Study of Screening for Prostate Cancer Risk calculator 3 (ERSPC RC3): A comparative study of cognitive, fusion and template prostate biopsy in the UK
Dr. Ajay Bhojwani
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Abstract
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Introduction
The use of risk calculators to improve the detection of prostate cancer has been recommended by EAU. ERSCP RC3 collates results from various diagnostic parameters to recommend whether a prostate biopsy is likely to yield clinically significant prostate cancer. To assess its value in the real-world setting, we applied the ERSCP RC3 in cognitive, fusion and template prostate biopsies across three NHS trusts in the West Midlands.
Patients (or Materials) and Methods
Data was collected non-sequentially over an 18-month period. Patients were allocated into low, medium and high risk based on ERSCP RC3 detectable cancer risk score. This was compared to clinically significant (Gleason score ≥7) prostate cancer and benign histology on biopsy.
Results
663 patients were initially identified, and 506 (76%) met the inclusion criteria for ERSCP RC3. In the low risk group across all three modalities, 66.5% (113/170) had benign histology. In the medium risk group across all three modalities, 49.3% (35/71) had benign histology. In the high risk group across all three modalities, 20.8% (55/265) had benign histology. As outlined in Table 1, the overall sensitivity and specificity was 0.787 and 0.764 respectively.
Conclusions
This study shows that the sensitivity and specificity of ERSCP RC3 was only adequate in cognitive and fusion biopsy. The use of ERSCP RC3 in our cohort would have prevented 113 unnecessary biopsies. We recommend using ERSCP RC3 as a screening tool for the diagnosis of prostate cancer.
The use of risk calculators to improve the detection of prostate cancer has been recommended by EAU. ERSCP RC3 collates results from various diagnostic parameters to recommend whether a prostate biopsy is likely to yield clinically significant prostate cancer. To assess its value in the real-world setting, we applied the ERSCP RC3 in cognitive, fusion and template prostate biopsies across three NHS trusts in the West Midlands.
Patients (or Materials) and Methods
Data was collected non-sequentially over an 18-month period. Patients were allocated into low, medium and high risk based on ERSCP RC3 detectable cancer risk score. This was compared to clinically significant (Gleason score ≥7) prostate cancer and benign histology on biopsy.
Results
663 patients were initially identified, and 506 (76%) met the inclusion criteria for ERSCP RC3. In the low risk group across all three modalities, 66.5% (113/170) had benign histology. In the medium risk group across all three modalities, 49.3% (35/71) had benign histology. In the high risk group across all three modalities, 20.8% (55/265) had benign histology. As outlined in Table 1, the overall sensitivity and specificity was 0.787 and 0.764 respectively.
Conclusions
This study shows that the sensitivity and specificity of ERSCP RC3 was only adequate in cognitive and fusion biopsy. The use of ERSCP RC3 in our cohort would have prevented 113 unnecessary biopsies. We recommend using ERSCP RC3 as a screening tool for the diagnosis of prostate cancer.
Introduction
The use of risk calculators to improve the detection of prostate cancer has been recommended by EAU. ERSCP RC3 collates results from various diagnostic parameters to recommend whether a prostate biopsy is likely to yield clinically significant prostate cancer. To assess its value in the real-world setting, we applied the ERSCP RC3 in cognitive, fusion and template prostate biopsies across three NHS trusts in the West Midlands.
Patients (or Materials) and Methods
Data was collected non-sequentially over an 18-month period. Patients were allocated into low, medium and high risk based on ERSCP RC3 detectable cancer risk score. This was compared to clinically significant (Gleason score ≥7) prostate cancer and benign histology on biopsy.
Results
663 patients were initially identified, and 506 (76%) met the inclusion criteria for ERSCP RC3. In the low risk group across all three modalities, 66.5% (113/170) had benign histology. In the medium risk group across all three modalities, 49.3% (35/71) had benign histology. In the high risk group across all three modalities, 20.8% (55/265) had benign histology. As outlined in Table 1, the overall sensitivity and specificity was 0.787 and 0.764 respectively.
Conclusions
This study shows that the sensitivity and specificity of ERSCP RC3 was only adequate in cognitive and fusion biopsy. The use of ERSCP RC3 in our cohort would have prevented 113 unnecessary biopsies. We recommend using ERSCP RC3 as a screening tool for the diagnosis of prostate cancer.
The use of risk calculators to improve the detection of prostate cancer has been recommended by EAU. ERSCP RC3 collates results from various diagnostic parameters to recommend whether a prostate biopsy is likely to yield clinically significant prostate cancer. To assess its value in the real-world setting, we applied the ERSCP RC3 in cognitive, fusion and template prostate biopsies across three NHS trusts in the West Midlands.
Patients (or Materials) and Methods
Data was collected non-sequentially over an 18-month period. Patients were allocated into low, medium and high risk based on ERSCP RC3 detectable cancer risk score. This was compared to clinically significant (Gleason score ≥7) prostate cancer and benign histology on biopsy.
Results
663 patients were initially identified, and 506 (76%) met the inclusion criteria for ERSCP RC3. In the low risk group across all three modalities, 66.5% (113/170) had benign histology. In the medium risk group across all three modalities, 49.3% (35/71) had benign histology. In the high risk group across all three modalities, 20.8% (55/265) had benign histology. As outlined in Table 1, the overall sensitivity and specificity was 0.787 and 0.764 respectively.
Conclusions
This study shows that the sensitivity and specificity of ERSCP RC3 was only adequate in cognitive and fusion biopsy. The use of ERSCP RC3 in our cohort would have prevented 113 unnecessary biopsies. We recommend using ERSCP RC3 as a screening tool for the diagnosis of prostate cancer.
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