Impact of the MyProstateScore (MPS) Test on the Clinical Decision to Undergo Prostate Biopsy: Results From a Contemporary Academic Practice

• Published in: Urology (Ridgewood, N.J.) N.J.), 2020-11, Vol.145, p.204-210
• Main Authors: Lebastchi, Amir H., Russell, Christopher M., Niknafs, Yashar S., Eyrich, Nicholas W., Chopra, Zoey, Botbyl, Rachel, Kabeer, Rana, Osawa, Takahiro, Siddiqui, Javed, Siddiqui, Rabia, Davenport, Matthew S., Mehra, Rohit, Tomlins, Scott A., Kunju, Lakshimi P., Chinnaiyan, Arul M., Wei, John T., Tosoian, Jeffrey J., Morgan, Todd M.
• Format: Article
• Language: English
• Subjects: Aged; Antigens, Neoplasm - urine; Biopsy; Clinical Decision-Making; Cohort Studies; Humans; Male; Middle Aged; Multiparametric Magnetic Resonance Imaging; Prostate - diagnostic imaging; Prostate - pathology; Prostate-Specific Antigen - blood; Prostatic Neoplasms - blood; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - pathology; Prostatic Neoplasms - urine
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2020.07.042

To evaluate the association of the MyProstateScore (MPS) urine test on the decision to undergo biopsy in men referred for prostate biopsy in urology practice. MPS testing was offered as an alternative to immediate biopsy in men referred to the University of Michigan for prostate biopsy from October 2013 through October 2016. The primary endpoint was the decision to perform biopsy. The proportion of patients undergoing biopsy was compared to predicted risk scores from the Prostate Cancer Prevention Trial risk calculator (PCPTrc). Analyses were stratified by the use of multiparametric magnetic resonance imaging (mpMRI). The associations of PCPTrc, MPS, and mpMRI with the decision to undergo biopsy were explored in a multivariable logistic regression model. Of 248 patients, 134 (54%) proceeded to prostate biopsy. MPS was significantly higher in biopsied patients (median 29 vs14, P < .001). The use of biopsy was strongly associated with MPS, with biopsy rates of 26%, 38%, 58%, 90%, and 85% in the first through fifth quintiles, respectively (P < .001). MPS association with biopsy persisted upon stratification by mpMRI. On multivariable analysis, MPS was strongly associated with the decision to undergo biopsy when modeled as both a continuous (odds ratio [OR] 1.05, 95%; confidence interval [CI] 1.04-1.08;