(Press-News.org) Contact information: Deborah Bach
media@fredhutch.org
206-667-2210
Fred Hutchinson Cancer Research Center
Researchers develop tool to determine individual risk of prostate cancer overdiagnosis
Nomogram aims to enable informed decision-making and personalized treatment
SEATTLE - Studies have found that prostate cancer is overdiagnosed in up to 42 percent of cases, prompting men to receive unnecessary treatment that can cause devastating side effects, including impotence and incontinence.
Now, researchers at Fred Hutchinson Cancer Research Center and the University of Washington have developed a personalized tool that can predict the likelihood of prostate cancer overdiagnosis. They announced their findings this week in the online issue of the Journal of the National Cancer Institute.
An overdiagnosed cancer is defined as one that would never cause symptoms or pose a risk to the patient, therefore not require treatment. Treatment of such cancers provides no benefit and can only cause harm.
The researchers created a nomogram, a graphical calculating device, that incorporates a patient's age, prostate-specific antigen (PSA) level and Gleason score - which grades prostate cancer tissue based on how it looks under a microscope - to determine the likelihood that screening-detected prostate cancer has been overdiagnosed.
The goal, said Roman Gulati, the study's lead author, is to provide patients and clinicians with a tool that can help them better determine personalized treatment options.
"Men with screen-detected prostate cancer are making decisions about treatment based on limited information about the chances that their cancer has been overdiagnosed," said Gulati, a statistical research associate in Fred Hutch's Public Health Sciences Division.
"We think this is a useful tool for patients and their providers because it helps to tailor knowledge of the risks and benefits of different treatment choices to their individual situations."
To develop the nomogram, the researchers created a virtual population model representing U.S. men aged 50 to 84 years from 1975 to 2005 and applied existing data on PSA levels, biopsy practices and cancer diagnosis patterns to learn about cancer progression in patients with and without screening. A virtual population was required since it was impossible to know how cancer may have progressed in real patients who were screened and subsequently treated.
The researchers, who also included University of Washington urologist John Gore, M.D., and biostatistician Lurdes Inoue, Ph.D., then overlaid screening and biopsy patterns on the model to determine when the men would have been diagnosed with and without screening, and which would have died of other causes.
They came up with a prediction model which estimates that the likelihood of overdiagnosis ranges from 2.9 to 88.1 percent depending on patient age, PSA level and Gleason score at diagnosis.
The biggest factor in overdiagnosis is age. While treatment may be warranted for a younger man with rapidly growing prostate cancer, its benefits are less clear for, say, a man in his 80s with a less aggressive form of the disease who is more likely to die from other causes before the cancer would become apparent.
While nomograms are common in prostate cancer research, the one developed by the Fred Hutch and UW researchers is the first to determine the likelihood of overdiagnosis on an individual level, said Ruth Etzioni, Ph.D., the paper's senior author.
"We're trying to help patients who are the most likely to be overdiagnosed to recognize it and not be afraid to be more conservative in their treatment," said Etzioni, a biostatistician, cancer modeler and member of the Hutch's Public Health Sciences Division.
Daniel Lin, M.D., a urologist at the University of Washington and an associate member of the Fred Hutch Public Health Sciences Division, said the nomogram could be a valuable tool for clinicians and patients
"This nomogram will provide clinically relevant information for both the provider and patient on which to base practical decision-making for newly diagnosed prostate cancer," he said. "We fully realize that many men do not need immediate treatment for their cancer and can be safely placed on an active surveillance protocol, and this important research will further clarify those who may avoid treatment versus those men who may benefit from attempted curative therapy."
Etzioni said the next step is to develop an interface and test the nomogram in a pilot study tentatively planned for later this year. She believes the new tool has tremendous potential to help the more than 230,000 American men diagnosed with prostate cancer annually.
"The big buzzword in prostate cancer is shared and informed decision-making," she said. "We want to make sure men are better informed."
INFORMATION:
The National Cancer Institute and the Centers for Disease Control and Prevention supported this research.
Editor's Note:
For a related article about the research of Etzioni, Gulati and Gore, click here.
At Fred Hutchinson Cancer Research Center, home to three Nobel laureates, interdisciplinary teams of world-renowned scientists seek new and innovative ways to prevent, diagnose and treat cancer, HIV/AIDS and other life-threatening diseases. Fred Hutch's pioneering work in bone marrow transplantation led to the development of immunotherapy, which harnesses the power of the immune system to treat cancer with minimal side effects. An independent, nonprofit research institute based in Seattle, Fred Hutch houses the nation's first and largest cancer prevention research program, as well as the clinical coordinating center of the Women's Health Initiative and the international headquarters of the HIV Vaccine Trials Network. Private contributions are essential for enabling Fred Hutch scientists to explore novel research opportunities that lead to important medical breakthroughs. For more information visit http://www.fredhutch.org or follow Fred Hutch on Facebook, Twitter or YouTube.
Researchers develop tool to determine individual risk of prostate cancer overdiagnosis
Nomogram aims to enable informed decision-making and personalized treatment
2014-01-10
ELSE PRESS RELEASES FROM THIS DATE:
Study: Athlete's first reaction in victory is dominance
2014-01-10
Study: Athlete's first reaction in victory is dominance
Body language, also called 'triumph,' stronger in victors from cultures that emphasize hierarchy
SAN FRANCISCO -- Upon victory, an athlete's initial and instinctive reaction is one that displays dominance ...
Researchers pursuing arthritis protein
2014-01-10
Researchers pursuing arthritis protein
Chronic inflammation poses something of a mystery for researchers. If we become infected, the body immediately takes steps to repair and tidy it up. This process manifests itself as inflammation, which stems from a high ...
Drought and downing equal vulture supermarkets
2014-01-09
Drought and downing equal vulture supermarkets
NEW YORK (EMBARGO: Wednesday, January 8, 2014 5 PM EST, USA) African vultures are famous for quickly finding carcasses; so much so that they are considered clairvoyants in parts of Africa. But just how do vultures ...
UCLA life scientists, colleagues differentiate microbial good and evil
2014-01-09
UCLA life scientists, colleagues differentiate microbial good and evil
To safely use bacteria in agriculture to help fertilize crops, it is vital to understand the difference between harmful and healthy strains. The bacterial genus Burkholderia, ...
Elephant shark genome provides new insights into bone formation and adaptive immunity in humans
2014-01-09
Elephant shark genome provides new insights into bone formation and adaptive immunity in humans
A*STAR-led international consortium completely decodes the first shark-family member genome
1. Singapore, Jan, 09, 2014 ...
Researchers discover how vascular disease activates autoimmune disorders
2014-01-09
Researchers discover how vascular disease activates autoimmune disorders
The hardening of the arteries, also called atherosclerosis, that can lead to heart attack or stroke. has also been linked to autoimmune disorders. It has not been clear why these diseases are related, ...
JCI early table of contents for Jan. 9, 2014
2014-01-09
JCI early table of contents for Jan. 9, 2014
Engineered anti-toxin antibodies improve efficacy
The effectiveness of toxin-neutralizing antibodies is considered to be mediated through the interaction of the variable region of the antibody and the toxin; ...
Engineered anti-toxin antibodies improve efficacy
2014-01-09
Engineered anti-toxin antibodies improve efficacy
The effectiveness of toxin-neutralizing antibodies is considered to be mediated through the interaction of the variable region of the antibody and the toxin; however, recent studies suggest that the constant ...
Mice exposed to retinoid deficiency in utero exhibit bronchial hyperresponsiveness as adults
2014-01-09
Mice exposed to retinoid deficiency in utero exhibit bronchial hyperresponsiveness as adults
Individuals with asthma and COPD are subject to debilitating bronchospasm as a result of airways that are hyperresponsive to stimuli. Factors that lead to the ...
Joslin researchers determine hormone linked to improved glucose metabolism activates browning of fat
2014-01-09
Joslin researchers determine hormone linked to improved glucose metabolism activates browning of fat
BOSTON – (January 9, 2013) – Researchers at Joslin Diabetes Center have discovered that a hormone long associated with weight loss and improved glucose metabolism ...
LAST 30 PRESS RELEASES:
AI can spot which patients need treatment to prevent vision loss in young adults
Half of people stop taking popular weight-loss drug within a year, national study finds
Links between diabetes and depression are similar across Europe, study of over-50s in 18 countries finds
Smoking increases the risk of type 2 diabetes, regardless of its characteristics
Scientists trace origins of now extinct plant population from volcanically active Nishinoshima
AI algorithm based on routine mammogram + age can predict women’s major cardiovascular disease risk
New hurdle seen to prostate screening: primary-care docs
MSU researchers explore how virtual sports aid mental health
Working together, cells extend their senses
Cheese fungi help unlock secrets of evolution
Researchers find brain region that fuels compulsive drinking
Mental health effects of exposure to firearm violence persist long after direct exposure
Research identifies immune response that controls Oropouche infection and prevents neurological damage
University of Cincinnati, Kent State University awarded $3M by NSF to share research resources
Ancient DNA reveals deeply complex Mastodon family and repeated migrations driven by climate change
Measuring the quantum W state
Researchers find a way to use antibodies to direct T cells to kill Cytomegalovirus-infected cells
Engineers create mini microscope for real-time brain imaging
Funding for training and research in biological complexity
The Journal of Nuclear Medicine Ahead-of-Print Tip Sheet: September 12, 2025
ISSCR statement on the scientific and therapeutic value of human fetal tissue research
Novel PET tracer detects synaptic changes in spinal cord and brain after spinal cord injury
Wiley advances Knowitall Solutions with new trendfinder application for user-friendly chemometric analysis and additional enhancements to analytical workflows
Benchmark study tracks trends in dog behavior
OpenAI, DeepSeek, and Google vary widely in identifying hate speech
Research spotlight: Study identifies a surprising new treatment target for chronic limb threatening ischemia
Childhood loneliness and cognitive decline and dementia risk in middle-aged and older adults
Parental diseases of despair and suicidal events in their children
Acupuncture for chronic low back pain in older adults
Acupuncture treatment improves disabling effects of chronic low back pain in older adults
[Press-News.org] Researchers develop tool to determine individual risk of prostate cancer overdiagnosisNomogram aims to enable informed decision-making and personalized treatment