The performance of prostate-specific antigen density in long-term prostate cancer-mortality risk prediction.

Authors

Sara Saliba, Anders Kjellman, Anna Thor, Ulf Norming, Anna Lantz, Ove Gustafsson, Per-Olof Lundgren

Published in

BJUI compass. Volume 7. Issue 7. Pages e70250. Epub Jul 10, 2026.

Abstract

The objective of this study is to examine whether a baseline calculation of PSAD is associated with prostate cancer-specific mortality after 30 years of follow-up.
One-thousand seven-hundred and seventy-nine men were screened for prostate cancer with a PSA test, digital rectal exam (DRE) and ultrasound of the prostate (TRUS). Outcomes, that is, prostate cancer-specific mortality, were extracted from the Swedish National Cause of Death Registry. Hazard ratios for cancer-specific deaths were estimated using Cox proportional hazard regression model. The area under the receiver operating curve (AUC) was determined using logistic regression for men with a baseline PSA in the interval between 3.0 and 10.0 ng/ml.
PSAD was available for 1748 men. Median PSAD was 0.095 ng/ml/cm³ (IQR 0.073-0.14). The age-adjusted hazard ratio for lethal prostate cancer in the cohort of men with PSA between 3.0 and 10.0 ng/ml was 10.1 (95% CI 2.4-42.2) if PSAD was ≥0.15 compared to <0.15.A model including PSAD, palpation and ultrasound findings could distinguish lethal prostate cancer from non-cases at 30 years of follow-up with an AUC of 0.75.
For men with PSA between 3 and 10 ng/ml, PSAD is a predictor of the long-term risk for lethal prostate cancer. One limitation to this study is the lack of clinical data during follow-up apart from cancer-specific mortality.

PMID:
42437045
Bibliographic data and abstract were imported from PubMed on 12 Jul 2026.

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