the volume of the prostate using the prolate ellipsoid volume calculation method. Crawford and Presti also discuss the role of PSA, PSA density, and molecular markers in calculating prostate cancer risk.įor more information on genomic testing and prostate cancer, visit our Next Generation Genomics & Biomarkers Learning Center. Comparison of Methods of Volume Measurement of the Prostate by. Presti suggests that patients who meet a certain risk threshold based on the calculator that does not include a DRE should then receive one. They discuss the difficulty of getting urologists and family practitioners to give digital rectal exams (DREs) since they have been found to be a deterrent to men getting screened. Presti, Jr., MD, FACS, Regional Leader of Urologic Oncology Surgery at Kaiser Permanente Northern California, about Kaiser Permanente’s new prostate cancer risk calculator. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology and Professor of Urology at the University of California, San Diego, interviews Joseph C. Presti notes that all of these models compare favorably to other risk calculators.Į. They created 3 different models based on this, with the simplest but least accurate including clinical core variables but no DRE and no prostate volume, the second-most accurate including DRE but no prostate volume, and the most accurate including DRE and prostate volume. Using TRIPOD guidelines (transparent reporting of a multivariable prediction model for individual prognosis or diagnosis) and the LASSO (least absolute shrinkage and selection operator) system of selection, Kaiser Permanente researchers determined that the variables that ought to be included in a prostate cancer prediction model are age, race, PSA, body-mass index, family history, number of prior negative biopsies, digital rectal exam (DRE), and prostate volume. Presti explains that older risk calculators tend to oversimplify variables like race, are based on outdated systematic biopsy schemes, and are often poorly calibrated due to the sampling frame used. Presti, Jr., MD, FACS, Regional Leader of Urologic Oncology Surgery at Kaiser Permanente Northern California, discusses the development of Kaiser Permanente’s new prostate cancer risk calculator and its merits. Presti, Jr., MD, FACS, presented “Kaiser Permanente Prostate Cancer Risk Calculator 1.0 ” for the Grand Rounds in Urology audience in September 2020.
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