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. 2018 Jun 8;1(2):e180219. doi: 10.1001/jamanetworkopen.2018.0219

Table 3. Comparison of Biopsy Strategya.

Significant Prostate Cancer Definition Biopsies, No. (% [95% CI])b Difference, % (95% CI) P Value, McNemar Test
Standard (All Men) Combined (modified PI-RADS 3-5) Absolute Relative
Men with biopsy performed 1020 (100 [99 to 100]) 715 (70 [67 to 73]) –30 (–33 to –27) –30 (–33 to –27) <.001
Biopsy cores, No. 9268 7339c –21 (–22 to –20) –21 (–22 to –20) <.001
No prostate cancer on biopsy 381 (37 [34 to 40]) 146 (14 [12 to 17]) –23 (–27 to –19) –62 (–68 to –55) <.001
Primary definition of significant prostate cancerd
Insignificant prostate cancer 288 (28 [26 to 31]) 173 (17 [15 to 19]) –11 (–15 to –8) –40 (–49 to –29) <.001
Significant prostate cancer 351 (34 [32 to 37]) 396 (39 [36 to 42]) 4 (0.2 to 9) 11 (0.6 to 21) <.001
Secondary definition of significant prostate cancere
Insignificant prostate cancer 262 (25 [23 to 29]) 145 (14 [12 to 17]) –11 (–15 to –8) –45 (–54 to –34) <.001
Significant prostate cancer 377 (37 [34 to 40]) 424 (42 [39 to 45]) 5 (0.4 to 9) 11 (0.9 to 21) <.001
Tertiary definition of significant prostate cancerf
Insignificant prostate cancer 198 (19 [17 to 22]) 115 (11 [9 to 13]) –8 (–11 to –5) –42 (–53 to –28) <.001
Significant prostate cancer 441 (43 [40 to 46]) 454 (45 [41 to 48]) 1 ( to 3 to 6) 3 (−7 to 12) .11

Abbreviation: PI-RADS, Prostate Imaging Reporting and Data System.

a

Comparison of the diagnostic strategies of standard biopsies in all men vs combined (standard plus targeted) biopsies restricted to men with suspicious biparametric magnetic resonance imaging findings (modified PI-RADS score 3-5) using different definitions of significant prostate cancer.

b

The total number of patients (N = 1020) was used as the denominator for calculating all percentages.

c

Includes 6231 standard biopsies and 1108 targeted biopsies.

d

Gleason score of 4 + 3 or greater or maximum cancer-core length greater than 50% with a Gleason score of 3 + 4. The prevalence was 404 men (40% [95% CI, 37%-43%]).

e

Gleason score of 4 + 3 or greater or maximum cancer-core length greater than 50% with any PCa. The prevalence was 436 men (43% [95% CI, 40%-46%]).

f

Gleason score of 3 + 4 or greater. The prevalence was 475 men (47% [95% CI, 44%-50%]).