Association of Prostate-Specific Antigen Levels with Prostate Cancer Risk in a Multiethnic Population: Stability over Time and Comparison with Polygenic Risk Score.

Studies in men of European ancestry suggest prostate-specific antigen (PSA) as a marker of early prostate cancer (PCa) development that may help to risk-stratify men earlier in life.

We examined PSA levels in men measured up to 10+ years before a PCa diagnosis in association with PCa risk in 2,245 cases and 2,203 controls of African American, Latino, Japanese, Native Hawaiian, and White men in the Multiethnic Cohort. We also compared the discriminative ability of PSA to polygenic risk score (PRS) for PCa.

Excluding cases diagnosed within 2 and 10 years of blood draw, men with PSA above the median had a PCa OR (95% CIs) of 9.12 (7.66-10.92) and 3.52 (2.50-5.03), respectively, compared to men with PSA below the median. A PSA level above the median identified 90% and 75% of cases diagnosed more than 2 and 10 years after blood draw, respectively. The associations were significantly greater for Gleason ≤7 vs. 8+ disease. At 10+ years, the association of PCa with PSA was comparable to that with the PRS (OR per SD increase: 1.88 (1.45-2.46) and 2.12 (1.55-2.93), respectively).

We found PSA to be an informative marker of PCa risk at least a decade before diagnosis across multiethnic populations. This association was diminished with increasing time, greater for low grade tumors, and comparable to a PRS when measured 10+ years before diagnosis.

Our multiethnic investigation suggests broad clinical implications on the utility of PSA and PRS for risk stratification in PCa screening practices.

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2022 Sep 20 [Epub ahead of print]

Alisha Chou, Burcu F Darst, Lynne R Wilkens, Loic Le Marchand, Hans Lilja, David V Conti, Christopher A Haiman

University of Southern California, Los Angeles, CA, United States., Fred Hutchinson Cancer Center, Seattle, WA, United States., University of Hawaii Cancer Center, Honolulu, HI, United States., University of Hawaii Cancer Center, Honolulu, Hawaii, United States., Memorial Sloan Kettering Cancer Center, New York, NY, United States., University of Southern California, Los Angeles, United States.

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