The Cancer Risk Calculator for Prostate Cancer was developed based upon 5519 men in the placebo group of the Prostate Cancer Prevention Trial. All of these 5519 men initially had a PSA value less than or equal to 3.0 ng/ml and were followed for seven years with annual PSA and digital rectal examination. If PSA exceeded 4.0 ng/ml or if an abnormal digital rectal examination was noted, a biopsy was recommended. After seven years, all men were recommended to have a prostate biopsy, regardless of PSA or rectal examination findings. PSA, family history, rectal examination findings, and history of a prior negative prostate biopsy provided independent predictive value to the calculation of risk of a biopsy that showed presence of cancer.

The results of this calculator may not apply to different groups of individuals. As about 80% of men had a prostate biopsy with six cores, if more than six cores are obtained at biopsy, a greater risk of cancer may be expected. Most men in this study were white and results may be different with other ethnicities or races.

The calculator is in principle only applicable to men under the following restrictions:

• Age 50 or older
• No previous diagnosis of prostate cancer
• DRE and PSA results less than 1 year old

This calculator is applicable for men who are undergoing prostate cancer screening with PSA and DRE as it was derived from a group of men in the Prostate Cancer Prevention Trial who underwent annual PSA and DRE. The risk estimate from the calculator does not reflect an endorsement of either PSA or DRE for screening for prostate cancer.

This calculator is designed to provide a preliminary assessment of risk of prostate cancer if a prostate biopsy is performed. Additional clinical information may modify this risk. No specific level of risk is recommended for prostate biopsy and this decision should be an individual choice based upon a physician-patient relationship.

If you have any question about the Prostate Cancer Risk Calculator, please send email to ankerst@uthscsa.edu.