ArticleWorld journal of urology2026
PSA density for clinically significant prostate cancer detection: a retrospective cohort study on the influence of age and prostate volume.
Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePSA density (PSAD) may improve detection of clinically significant prostate cancer (csPCa) by normalizing PSA for prostate volume. Current practice applies a uniform PSAD threshold of 0.15 ng/ml/cm³; however, whether this approach performs adequately across prostate volumes remains unclear. This study evaluated the diagnostic performance of PSAD for csPCa and investigated the influence of age and prostate volume on its accuracy.
methodsA total of 3,923 MRI-guided biopsy sessions from 3,087 patients were retrospectively analyzed. PSAD was calculated from total PSA (ng/ml) and MRI-derived prostate volume (cm³). ROC analysis determined AUC and Youden-optimal cut-offs, stratified by age (< 60, 60-69, ≥ 70 years) and prostate volume (< 30, 30-50, > 50 cm³), with bootstrap CIs.
resultsOverall AUC was 0.758 (95% CI 0.743-0.773). Optimal cut-offs varied substantially by volume: 0.246 ng/ml/cm³ (95% CI 0.156-0.292) for small (< 30 cm³, AUC 0.717), 0.144 ng/ml/cm³ (0.124-0.178) for moderate (30-50 cm³, AUC 0.734), and 0.124 ng/ml/cm³ (0.102-0.162) for large prostates (> 50 cm³, AUC 0.702). Accuracy deteriorated progressively in very large prostates (AUC 0.658 for > 80 cm³, 0.609 for > 120 cm³). At volumes > 80 cm³, the 0.15 ng/ml/cm³ threshold achieved only 33.1% sensitivity. Age showed minimal clinical impact (AUC improvement 0.019).
conclusionA universal 0.15 ng/ml/cm³ PSAD threshold fails to account for prostate volume variability. Potential volume-adapted cut-offs (0.25 / 0.15 / 0.12 ng/ml/cm³ for < 30 / 30-50 / >50 cm³) better approximate stratum-specific optimal values, although continuous multivariable risk prediction outperformed any fixed-threshold strategy and PSAD is interpreted alongside MRI in practice. Alternative biomarkers should be considered for very large prostates where PSAD accuracy deteriorates. These findings are hypothesis-generating and require external validation with PI-RADS integration before potential guideline implementation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.