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               <dc:title>Evaluation of the 4Kscore Test in Relation to Subsequent Risk of Aggressive Prostate Cancer in the European Prospective Investigation into Cancer and Nutrition</dc:title>
               <dc:creator>Smith-Byrne, Karl</dc:creator>
               <dc:creator>Fensom, Georgina K.</dc:creator>
               <dc:creator>Noor, Urwah</dc:creator>
               <dc:creator>Watts, Eleanor L.</dc:creator>
               <dc:creator>Allen, Naomi E.</dc:creator>
               <dc:creator>Amiano, Pilar</dc:creator>
               <dc:creator>Chirlaque, María Dolores</dc:creator>
               <dc:creator>Crous Bou, Marta</dc:creator>
               <dc:creator>Guevara Eslava, Marcela</dc:creator>
               <dc:creator>Palli, Domenico</dc:creator>
               <dc:creator>Katzke, Verena</dc:creator>
               <dc:creator>Sacerdote, Carlotta</dc:creator>
               <dc:creator>Sánchez Pérez, María José</dc:creator>
               <dc:creator>Schulze, Matthias B.</dc:creator>
               <dc:creator>Sieri, Sabina</dc:creator>
               <dc:creator>Tumino, Rosario</dc:creator>
               <dc:creator>Tsilidis, Konstantinos K.</dc:creator>
               <dc:creator>Kaaks, Rudolf</dc:creator>
               <dc:creator>Gunter, Marc J.</dc:creator>
               <dc:creator>Riboli, Elio</dc:creator>
               <dc:creator>Key, Timothy J.</dc:creator>
               <dc:creator>Travis, Ruth C.</dc:creator>
               <dc:subject>Càncer de pròstata</dc:subject>
               <dc:subject>Antigen específic de la pròstata</dc:subject>
               <dc:subject>Prostate cancer</dc:subject>
               <dc:subject>Prostate-specific antigen</dc:subject>
               <dc:description>Background: 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. Methods: 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 were analyzed. Discrimination for the 4Kscore and total PSA was assessed using the AUC with 95% confidence intervals (CI) via bootstrapping. Results: For high-grade tumors, AUCs were 0.69 (95% CI, 0.66-0.72) for the 4Kscore and 0.75 (95% CI, 0.73-0.78) for total PSA. For advanced-stage disease, AUCs were 0.71 (95% CI, 0.66-0.75) for the 4Kscore and 0.77 (95% CI, 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 &lt;60 years at recruitment. Conclusions: In this large European study, the 4Kscore did not significantly improve the prediction of clinically significant prostate cancer compared with total PSA, except in younger men with elevated PSA. Impact: 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.</dc:description>
               <dc:date>2025-11-27T14:07:35Z</dc:date>
               <dc:date>2025-11-27T14:07:35Z</dc:date>
               <dc:date>2025-08-22</dc:date>
               <dc:date>2025-11-27T11:24:28Z</dc:date>
               <dc:type>info:eu-repo/semantics/article</dc:type>
               <dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
               <dc:relation>Reproducció del document publicat a: https://doi.org/10.1158/1055-9965.EPI-24-1877</dc:relation>
               <dc:relation>Cancer Epidemiology Biomarkers &amp; Prevention, 2025, vol. 34, num. 11, p. 2058-2067</dc:relation>
               <dc:relation>https://doi.org/10.1158/1055-9965.EPI-24-1877</dc:relation>
               <dc:rights>cc-by (c) Smith-Byrne, Karl et al., 2025</dc:rights>
               <dc:rights>http://creativecommons.org/licenses/by/3.0/es/</dc:rights>
               <dc:rights>info:eu-repo/semantics/openAccess</dc:rights>
               <dc:publisher>American Association for Cancer Research (AACR)</dc:publisher>
               <dc:source>Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))</dc:source>
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