Review Article | Published:

Approaches to urinary detection of prostate cancer

Prostate Cancer and Prostatic Diseases (2019) | Download Citation

Abstract

Background

Prostate cancer is the most common cancer in American men that ranges from low risk states amenable to active surveillance to high-risk states that can be lethal especially if untreated. There is a critical need to develop relatively non-invasive and clinically useful methods for screening, detection, prognosis, disease monitoring, and prediction of treatment efficacy. In this review, we focus on important advances as well as future efforts needed to drive clinical innovation in this area of urine biomarker research for prostate cancer detection and prognostication.

Methods

We provide a review of current literature on urinary biomarkers for prostate cancer. We evaluate the strengths and limitations of a variety of approaches that vary in sampling strategies and targets measured; discuss reported urine tests for prostate cancer with respect to their technical, analytical, and clinical parameters; and provide our perspectives on critical considerations in approaches to developing a urine-based test for prostate cancer.

Results

There has been an extensive history of exploring urine as a source of biomarkers for prostate cancer that has resulted in a variety of urine tests that are in current clinical use. Importantly, at least three tests have demonstrated high sensitivity (~90%) and negative predictive value (~95%) for clinically significant tumors; however, there has not been widespread adoption of these tests.

Conclusions

Conceptual and methodological advances in the field will help to drive the development of novel urinary tests that in turn may lead to a shift in the clinical paradigm for prostate cancer diagnosis and management.

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Acknowledgements

We acknowledge funding support from the Prostate Cancer Foundation, Urological Research Foundation, and NIH grants U54CA199091, P50CA180995, and X01HG009642 to WJC.

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Affiliations

  1. Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    • Jillian N. Eskra
    • , Daniel Rabizadeh
    • , Christian P. Pavlovich
    •  & Jun Luo
  2. Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    • William J. Catalona

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Conflict of interest

WJC is a consultant/advisory board member for Beckman Coulter and has received commercial research support from Beckman Coulter, DeCode Genetics, and Ohmx. JL, CPP, JNE, and DR declare no conflict of interest.

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Correspondence to Jun Luo.

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https://doi.org/10.1038/s41391-019-0127-4