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Online prostate-cancer diagnostic underestimates patients' risk of having advanced tumor

An Internet-based tool determine a patient's risk of having an aggressive case of prostate cancer, called the Prostate Cancer Risk Calculator, or PCRC, is used frequently by front-line providers and, increasingly, by patients themselves. The user plugs in some numbers from lab tests, answers some questions on family history and the patient's previous examination results, and out pop two percentages: one for the chances of having prostate cancer, and another for the likelihood of having an advanced case. It's the latter kind that really needs immediate attention, as most prostate tumors are very slow-growing and not likely to cause significant harm.

But a just-published study, led by Stanford's Joe Presti, MD, says the PCRC systematically understates patients' risk of having an advanced tumor. Presti, concerned that on the basis of the faulty estimate patients who really should be getting a biopsy may decide not to, is developing a better formula based on a more relevant database than the one used to generate the PCRC.

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