Gene-prostate-specific-antigen-guided personalized screening for prostate cancer

Teng Kai Yang, Pi Chun Chuang, Amy Ming Fang Yen, Hsiu Hsi Chen, Sam Li Sheng Chen

研究成果: 雜誌貢獻文章

摘要

(1) Background: A simulation approach for prostate cancer (PrCa) with a prostate-specific antigen (PSA) test incorporating genetic information provides a new avenue for the development of personalized screening for PrCa. Going by the evidence-based principle, we use the simulation method to evaluate the effectiveness of mortality reduction resulting from PSA screening and its utilization using a personalized screening regime as opposed to a universal screening program. (2) Methods: A six-state (normal, over-detected, low-grade, and high-grade PrCa in pre-clinical phase, and low-grade and high-grade PrCa in clinical phase) Markov model with genetic and PSA information was developed after a systematic review of genetic variant studies and dose-dependent PSA studies. This gene-PSA-guided model was used for personalized risk assessment and risk stratification. A computer-based simulated randomized controlled trial was designed to estimate the reduction of mortality achieved by three different screening methods, personalized screening, universal screening, and a non-screening group. (3) Results: The effectiveness of PrCa mortality reduction for a personalized screening program compared to a non-screening group (22% (9%-33%)) was similar to that noted in the universal screening group (20% (7%-21%). However, a personalized screening program could dispense with 26% of unnecessary PSA testing, and avoid over-detection by 2%. (4) Conclusions: Gene-PSA-guided personalized screening for PrCa leads to fewer unnecessary PSA tests without compromising the benefits of mortality reduction (as happens with the universal screening program).
原文英語
文章編號641
期刊Genes
10
發行號9
DOIs
出版狀態已發佈 - 九月 1 2019

指紋

Prostate-Specific Antigen
Prostatic Neoplasms
Genes
Mortality
Genetic Models
Randomized Controlled Trials

ASJC Scopus subject areas

  • Genetics
  • Genetics(clinical)

引用此文

Gene-prostate-specific-antigen-guided personalized screening for prostate cancer. / Yang, Teng Kai; Chuang, Pi Chun; Yen, Amy Ming Fang; Chen, Hsiu Hsi; Chen, Sam Li Sheng.

於: Genes, 卷 10, 編號 9, 641, 01.09.2019.

研究成果: 雜誌貢獻文章

Yang, Teng Kai ; Chuang, Pi Chun ; Yen, Amy Ming Fang ; Chen, Hsiu Hsi ; Chen, Sam Li Sheng. / Gene-prostate-specific-antigen-guided personalized screening for prostate cancer. 於: Genes. 2019 ; 卷 10, 編號 9.
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abstract = "(1) Background: A simulation approach for prostate cancer (PrCa) with a prostate-specific antigen (PSA) test incorporating genetic information provides a new avenue for the development of personalized screening for PrCa. Going by the evidence-based principle, we use the simulation method to evaluate the effectiveness of mortality reduction resulting from PSA screening and its utilization using a personalized screening regime as opposed to a universal screening program. (2) Methods: A six-state (normal, over-detected, low-grade, and high-grade PrCa in pre-clinical phase, and low-grade and high-grade PrCa in clinical phase) Markov model with genetic and PSA information was developed after a systematic review of genetic variant studies and dose-dependent PSA studies. This gene-PSA-guided model was used for personalized risk assessment and risk stratification. A computer-based simulated randomized controlled trial was designed to estimate the reduction of mortality achieved by three different screening methods, personalized screening, universal screening, and a non-screening group. (3) Results: The effectiveness of PrCa mortality reduction for a personalized screening program compared to a non-screening group (22{\%} (9{\%}-33{\%})) was similar to that noted in the universal screening group (20{\%} (7{\%}-21{\%}). However, a personalized screening program could dispense with 26{\%} of unnecessary PSA testing, and avoid over-detection by 2{\%}. (4) Conclusions: Gene-PSA-guided personalized screening for PrCa leads to fewer unnecessary PSA tests without compromising the benefits of mortality reduction (as happens with the universal screening program).",
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