Sojourn-time-corrected Receiver Operating Characteristic Curve (ROC) for Prostate Specific Antigen (PSA) Test in Population-based Prostate Cancer Screening

Overview

Journal Sci Rep

Specialty Science

Date 2020 Nov 27

PMID 33244038

Authors

Hsiao-Hsuan Jen

Wei-Jung Chang

Chen-Yang Hsu

Amy Ming-Fang Yen

Anssi Auvinen

Tony Hsiu-Hsi Chen

Sam Li-Sheng Chen

Affiliations

Soon will be listed here.

Abstract

Evaluating the performance of serum prostate-specific antigen (PSA) test in population-based screening with receiver operating characteristics (ROC) curve often neglects the time dimension. Asymptomatic cases with negative PSA test would have been missed if sojourn time is not taken into account to allow for cases surfacing into the clinical phase. Data included 20,796 men with PSA test at the first screening round was used from population-based Finnish prostate cancer screening trial during 1996-1999. Cancers detected at the first screen, together with interval cancers ascertained during 4-year follow-up were expediently used to estimate sensitivity and specificity. A sojourn-time-corrected model was applied to estimating the possible false negative cases for those with PSA < 4 ng/ml for correcting the ROC curve. The estimated sensitivity estimate was reduced from 94.4% without correction to 68.8% with correction but the estimated specificity was identical (89.4% vs. 89.2%) at cutoff of 3 ng/ml. The corrected area under curve (AUC) [77.0% (74.9-79.1%)] of the PSA test was significantly lower than the uncorrected AUC [95.9% (95.3-96.6%)]. The failure of considering the time since last negative screen due to incomplete ascertainment for asymptomatic cancer led to the overestimation of PSA test performance that further affects the cut-off value of PSA tests for population-based prostate cancer screening.

References

Holmstrom B, Johansson M, Bergh A, Stenman U, Hallmans G, Stattin P . Prostate specific antigen for early detection of prostate cancer: longitudinal study. BMJ. 2009; 339:b3537. PMC: 2751815. DOI: 10.1136/bmj.b3537. View

Wu G, Auvinen A, Yen A, Hakama M, Walter S, Chen H . A stochastic model for survival of early prostate cancer with adjustments for leadtime, length bias, and over-detection. Biom J. 2012; 54(1):20-44. DOI: 10.1002/bimj.201000107. View

Hara I, Miyake H, Hara S, Yamada Y, Takechi Y, Fujisawa M . Significance of prostate-specific antigen--alpha(1)-antichymotrypsin complex for diagnosis and staging of prostate cancer. Jpn J Clin Oncol. 2001; 31(10):506-9. DOI: 10.1093/jjco/hye104. View

Yen A, Chen H . Modeling the overdetection of screen-identified cancers in population-based cancer screening with the Coxian phase-type Markov process. Stat Med. 2019; 39(5):660-673. DOI: 10.1002/sim.8437. View

Hui-Min W, Ming-Fang Y, Chen T . SAS macro program for non-homogeneous Markov process in modeling multi-state disease progression. Comput Methods Programs Biomed. 2004; 75(2):95-105. DOI: 10.1016/j.cmpb.2003.12.001. View

Samuelson F, Abbey C . Using Relative Statistics and Approximate Disease Prevalence to Compare Screening Tests. Int J Biostat. 2016; 12(2). PMC: 5947324. DOI: 10.1515/ijb-2016-0017. View

Djavan B, Zlotta A, Remzi M, Ghawidel K, Basharkhah A, Schulman C . Optimal predictors of prostate cancer on repeat prostate biopsy: a prospective study of 1,051 men. J Urol. 2000; 163(4):1144-8; discussion 1148-9. View

Cronin A, Vickers A . Statistical methods to correct for verification bias in diagnostic studies are inadequate when there are few false negatives: a simulation study. BMC Med Res Methodol. 2008; 8:75. PMC: 2600821. DOI: 10.1186/1471-2288-8-75. View

Chen T, Kuo H, Yen M, Lai M, Tabar L, Duffy S . Estimation of sojourn time in chronic disease screening without data on interval cases. Biometrics. 2000; 56(1):167-72. DOI: 10.1111/j.0006-341x.2000.00167.x. View

10.

Day N, Walter S . Simplified models of screening for chronic disease: estimation procedures from mass screening programmes. Biometrics. 1984; 40(1):1-14. View

11.

Jacobsen S, Bergstralh E, Guess H, Katusic S, Klee G, Oesterling J . Predictive properties of serum-prostate-specific antigen testing in a community-based setting. Arch Intern Med. 1996; 156(21):2462-8. View

12.

Finne P, Stenman U, Maattanen L, Makinen T, Tammela T, Martikainen P . The Finnish trial of prostate cancer screening: where are we now?. BJU Int. 2004; 92 Suppl 2:22-6. DOI: 10.1111/j.1465-5101.2003.04397.x. View

13.

Thompson I, Pauler D, Goodman P, Tangen C, Lucia M, Parnes H . Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. N Engl J Med. 2004; 350(22):2239-46. DOI: 10.1056/NEJMoa031918. View

14.

Wu D, Rosner G, Broemeling L . MLE and Bayesian inference of age-dependent sensitivity and transition probability in periodic screening. Biometrics. 2006; 61(4):1056-63. PMC: 1540406. DOI: 10.1111/j.1541-0420.2005.00361.x. View

15.

Chen S, Fann J, Sipeky C, Yang T, Chiu S, Yen A . Risk Prediction of Prostate Cancer with Single Nucleotide Polymorphisms and Prostate Specific Antigen. J Urol. 2018; 201(3):486-495. DOI: 10.1016/j.juro.2018.10.015. View

16.

Yang T, Chuang P, Yen A, Chen H, Chen S . Gene‒Prostate-Specific-Antigen-Guided Personalized Screening for Prostate Cancer. Genes (Basel). 2019; 10(9). PMC: 6770934. DOI: 10.3390/genes10090641. View

17.

Morgan T, Jacobsen S, McCarthy W, Jacobson D, McLeod D, Moul J . Age-specific reference ranges for serum prostate-specific antigen in black men. N Engl J Med. 1996; 335(5):304-10. DOI: 10.1056/NEJM199608013350502. View

18.

Maattanen L, Auvinen A, Stenman U, Tammela T, Rannikko S, Aro J . Three-year results of the Finnish prostate cancer screening trial. J Natl Cancer Inst. 2001; 93(7):552-3. DOI: 10.1093/jnci/93.7.552. View

19.

Teppo L, Pukkala E, Lehtonen M . Data quality and quality control of a population-based cancer registry. Experience in Finland. Acta Oncol. 1994; 33(4):365-9. DOI: 10.3109/02841869409098430. View

20.

Thompson I, Ankerst D, Chi C, Lucia M, Goodman P, Crowley J . Operating characteristics of prostate-specific antigen in men with an initial PSA level of 3.0 ng/ml or lower. JAMA. 2005; 294(1):66-70. DOI: 10.1001/jama.294.1.66. View