% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @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}, }