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@ARTICLE{SmithByrne:304090,
      author       = {K. Smith-Byrne and G. K. Fensom and U. Noor and E. L. Watts
                      and N. E. Allen and P. Amiano and M. D. Chirlaque and M.
                      Crous-Bou and M. Guevara Eslava and D. Palli and V.
                      Katzke$^*$ and C. Sacerdote and M.-J. Sánchez and M. B.
                      Schulze and S. Sieri and R. Tumino and K. K. Tsilidis and R.
                      Kaaks$^*$ and M. J. Gunter and E. Riboli and T. J. Key and
                      R. C. Travis},
      title        = {{E}valuation of the 4{K}score test in relation to
                      subsequent risk of aggressive prostate cancer in the
                      {E}uropean {P}rospective {I}nvestigation into {C}ancer and
                      {N}utrition.},
      journal      = {Cancer epidemiology, biomarkers $\&$ prevention},
      volume       = {nn},
      issn         = {1055-9965},
      address      = {Philadelphia, Pa.},
      publisher    = {AACR},
      reportid     = {DKFZ-2025-01758},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {Prostate-specific antigen (PSA) is central to referrals for
                      prostate biopsy but has low specificity for aggressive
                      prostate cancer. This study evaluates the 4Kscore® (OPKO
                      Diagnostics) versus total PSA in predicting short- and
                      long-term risks of aggressive prostate cancer.Baseline blood
                      samples from 1,658 men diagnosed with prostate cancer
                      (median diagnosis time = 8.6 years) and 1,658 matched
                      controls in the European Prospective Investigation into
                      Cancer and Nutrition (EPIC) were analyzed. Discrimination
                      for the 4Kscore and total PSA was assessed using the area
                      under the curve (AUC) with $95\%$ confidence intervals (CI)
                      via bootstrapping.For high-grade tumors, AUCs were 0.69
                      $(95\%$ CI: 0.66-0.72) for the 4Kscore and 0.75 (0.73-0.78)
                      for total PSA. For advanced-stage disease, AUCs were 0.71
                      (0.66-0.75) for the 4Kscore and 0.77 (0.73-0.80) for total
                      PSA. Similar findings were observed for other aggressive
                      cancer endpoints. Among men with PSA > 2 ng/mL, the 4Kscore
                      had better discrimination than PSA for overall prostate
                      cancer, high-grade disease, and prostate cancer death, but
                      only in men <60 years at recruitment.In this large European
                      study, the 4Kscore did not significantly improve the
                      prediction of clinically significant prostate cancer
                      compared to total PSA, except in younger men with elevated
                      PSA.The findings underscore the limited utility of the
                      4Kscore in improving medium to longer term risk prediction
                      over PSA, with potential benefits restricted to younger men
                      with elevated PSA.},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40844611},
      doi          = {10.1158/1055-9965.EPI-24-1877},
      url          = {https://inrepo02.dkfz.de/record/304090},
}