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PSA changes and prostate cancer characteristics and mortality

Principal Investigator
Name
Jonathan Shoag
Degrees
M.D.
Institution
University Hospitals
Position Title
Assistant Professor
Email
About this CDAS Project
Study
PLCO (Learn more about this study)
Project ID
PLCO-1930
Initial CDAS Request Approval
Jun 25, 2025
Title
PSA changes and prostate cancer characteristics and mortality
Summary
This project will use yearly Prostate Specific Antigen (PSA) data from the screening arm of the PLCO trial to assess the relationship between PSA values, and their change, with rates of prostate cancer (PCa) diagnosis, the characteristics of prostate cancer (gleason, stage), and mortality (all cause and prostate cancer specific). The questions addressed will be as follows: (1) How does PCa specific mortality vary as a function of final PSA value? (2) Same as 1 but for all cause mortality. (3) Among those diagnosed with advanced PCa (gleason >= 8) versus those diagnosed with less severe forms or no diagnosis of PCa what is the trajectory of PSA values across the yearly screening waves.
Aims

* In the screening arm of the PLCO trial, assess the association between final assessed Prostate Specific Antigen (PSA) level and prostate cancer specific mortality and all-cause mortality. We will use regression splines to model the continuous relationship between PSA and mortality, as opposed to breaking PSA into (arbitrary) categories.
* Assess whether age (within the range included in PLCO) moderates the relationship between final PSA and prostate cancer specific/all cause mortality.
* Compare PSA trajectory (change across the 5 yearly assessments) between those diagnoses with advanced prostate cancer at initial diagnosis, those with less advanced prostate cancer at initial diagnosis, and those never diagnosed.

Collaborators

Jonathan Shoag, M.D. Urology Institute, University Hospitals Cleveland Medical Center. School of Medicine, Case Western Reserve University
Stephen Rhodes, Ph.D. Urology Institute, University Hospitals Cleveland Medical Center.