Developing a risk calculator for the early detection of prostate cancer

Principal Investigator

Name
Visalini Nair-Shalliker

Degrees
BSc (Hons) MSc, MPH, PhD

Institution
The Daffodil Centre, The University Sydney, and Cancer Council,NSW

Position Title
Senior Research Fellow

Email
visalinin@nswcc.org.au

About this CDAS Project

Study
PLCO (Learn more about this study)

Project ID
PLCO-1993

Initial CDAS Request Approval
Dec 22, 2025

Title
Developing a risk calculator for the early detection of prostate cancer

Summary
Prostate cancer (PC) can be effectively managed with curative treatment when the cancer is localised to the prostate. Early detection can be achieved using a simple blood test, the prostate specific antigen (PSA) test. We propose to develop a PC risk-calculator based on established predictors of advanced PC, using data from the prospective cohort study.
Our risk-calculator will help identify asymptomatic men in the general population who have an above average risk of aggressive PC. Coupled with currently available decision-aids, this risk-calculator can act as a personalised decision-making tool to initiate a tailored discussion between patients and general practitioners (GPs) in communicating and comprehending PC risk. This will assist the shared decision-making process for PSA testing, that is, assist in deciding if PSA testing is needed for patient. If used widely and wisely, this will save lives.
This risk calculator will be a public facing web-based application and freely available, with user friendly explanations for members of the public to independently self-assess their own risk but also do this with primary healthcare.

Aims

We aim to develop a PC risk-calculator to facilitate PC risk communication between patients and GPs and assist their shared decision-making process for PSA testing.
Approximately 3500 Australian men die of PC annually. The rising incidence of advanced PC suggests missed opportunities for earlier diagnosis in high-risk men. Early detection using PSA testing has no systematic screening program, due to risk of overdiagnosis and overtreatment of non-significant PC. Although various resources are available to assist the decision-making process for PSA testing, this is difficult without suitable tools/aids, and their effectiveness is not well-documented. A tool to assist earlier identification of high-risk men that will subsequently facilitate the decision-making process, is urgently needed. Review of the Australian PSA testing guidelines are currently underway (by Cl team-Daffodil Centre). It is critical that good evidence is used to improve the decision-making process for PSA testing.
We will develop a highly reliable PC risk-calculator for use in general population, based on established evidence. Machine learning algorithms will be used to develop prediction models using the 45Up, which will provide robust evaluations with best predictive power and performance. We will internally validate the risk-calculator in a sub-sample of the 45Up, to assess clinical utility.

Collaborators

Visalini Nair-Shalliker University of Sydney
Pavla Vaneckova The Daffodil Centre, The University Sydney, and Cancer Council,NSW
Rani Radhika Chand The Daffodil Centre, The University Sydney, and Cancer Council,NSW