# risk calculator for prostate cancer….would my numbers have changed anything? is this a circle and we end up where we were i.e. a certain percentage chance of prostate cancer? at what percentage does one “pull da trigger?”

“And the universe is a lot like the earth, if you go straight around you end up where you were, and the universe is a lot like the earth….”
Modest Mouse

So I put my numbers in the risk calculator and come up with a 41% chance of prostate cancer. The only abnormality or risk  was a slightly elevated PSA. So…we are back to doing a biopsy on an elevated PSA…what did this do for us?

For years I have been offering the Free PSA to patients who felt they needed more evidence to proceed to biopsy or were “biopsy reluctant”. It almost always comes back somewhere in the middle…i.e. “You have a 18% chance of a positive biopsy.” It doesn’t help that much…so it’s 18%…what would you do? You still don’t know what percentage of 100 “you” are.

Now about me…I had the elevated PSA and was debating my options and elected to do a Free PSA (no that doesn’t mean that you don’t have to pay for it) and it was very low. Well…that helped me. But if you are in the middle range of things it doesn’t help much. It goes back to your anxiety level…an anxious person will act on 15% chance where a non anxious type person will need a more dramatic number.

I think the risk calculator doesn’t hurt anything. But what is funny is that we are back to what we already knew and that is a high PSA, a family history of prostate cancer and being black puts one at an increased risk of prostate cancer and begins the consideration of having a prostate biopsy done.

What would be your cut off percentage number? What would do it for you? Well…that’s the problem.

Individualized Risk Assessment of Prostate Cancer-The following are my numbers and the risk.
Results
Based on the data provided, the person’s estimated risk of biopsy-detectable prostate cancer is 41%.The 95% Confidence Interval for this prediction is 37.8% to 44.1%.

The person’s estimated risk of biopsy-detectable high grade prostate cancer is 8.5%.

The 95% Confidence Interval for this prediction is 5.3% to 11.6%.

Race Caucasian
Age 55
PSA Level 5.4 ng/ml
Family History of Prostate Cancer No
Digital Rectal Examination Normal
Prior Prostate Biopsy Never Had A Biopsy

## 2 Replies to “risk calculator for prostate cancer….would my numbers have changed anything? is this a circle and we end up where we were i.e. a certain percentage chance of prostate cancer? at what percentage does one “pull da trigger?””

1. Dr Jo-an Baldwin Peters says:

This is an interesting risk calculator for prostate cancer but it still goes back to PSA, DRE and genetic factors. Choices to have a biopsy are also dependant on the risk acceptance and aversion of the man. Health and age are yet another factor.
Your decision sheet covers most of these factors and I bet it could be developed as an alternate “risk calculator.”

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