Page 31 - Layout 1

UTHSCSA
smoking, diet, weight and other patterns of risk.
One of the most significant outcomes of the SABOR research is
the online Prostate Cancer Risk Calculator which gets right to the
goal of the program — creating tools to help physicians and their
patients decide if the patient should have a prostate biopsy after re-
ceiving a PSA test result that is outside of what is considered the “nor- tion Trial (PCPT), which looked at nearly 19,000 healthy men with-
mal” range. It’s a sophisticated discussion most doctors are not
equipped for and this tool combines many different factors into an
easy-to-interpret risk profile.
The calculator’s architect is faculty member Donna Ankerst, PhD,
a biostatistician who trained at the Harvard University School of
Public Health. Dr. Ankerst designed the algorithm for the online cal-
culator which sees about 100,000 hits a month from countries all
over the world. Launched in 2006 and updated several times since
then to reflect new findings, the most recent version (2.0) of the cal-
culator incorporates the % free-PSA result and was validated by a
study published in the June 2014 journal Urology. (PSA is found ei-
ther bound to other proteins or on its own, which is called “free
PSA”. The typical PSA test measures the total of both free and bound
PSA. The free-PSA test reports the percentage of unbound PSA.)
I put “normal” in quotes when referring to PSA results because
DEAN’S MESSAGE
historically, and even today, a PSA of 0-4 (ng/mL) is considered nor-
mal and >4 is abnormal. Drs. Thompson and Ankerst demonstrated
in a paper published in JAMA that this is not an accurate indicator
for prostate cancer or a biopsy. The paper, published in 2005
(JAMA. 2005;294(1):66-70), uses data from another historic study
conducted by our Urology Department, the Prostate Cancer Preven-
out prostate cancer and a PSA of three or less. I’ll quote the abstract’s
conclusion directly: “There is no cutpoint of PSA with simultaneous
high sensitivity and high specificity for monitoring healthy men for
prostate cancer, but rather a continuum of prostate cancer risk at all
values of PSA.” More simply, PSA is a factor, but alone it has too
much variability in regards to prostate cancer. This is why the
SABOR program is so important.
The other significant contribution made by the SABOR program
is the creation of its comprehensive data and tissue collection which
has resulted in it becoming the premiere institute in the world for
testing other predictors of prostate cancer. SABOR is a NCI (Na-
tional Cancer Institute) EDRN (Early Detection Research Network)
sponsored Clinical Validation Center. This means other researchers
around the world request tissue samples from the SABOR collection,
Continued on page 32
visit us at www.bcms.org 31