Background: The level of prostate-specific antigen (PSA) was reported to be reduced in type 2 diabetes mellitus (T2DM) . Possible low PSA levels in T2DM patients reduce the sensitivity of prostatic cancer (PCa) screening. To improve the effectiveness of early PCa screening inT2DM, it is necessary to establish a new PSA threshold for T2DM patients.

Methods: We retrospectively analyzed the clinical data of 2151 patients who underwent prostate biopsy for the first time admitted to Shanghai Tenth People′s Hospital from January 20to March 2020. The distribution of PSA was estimated by fitting a probability function. Machine learning methods was used to find a new threshold for PCa screening in T2DM.

Results: This study found that the PSA level in T2DM was lower than the regular patients. The new PCa screening threshold for T2DM was PSA=3.27 ng/mL. Meanwhile, the possible influence of age and body mass index (BMI) on the threshold were excluded. Compared with 4ng/mL, the sensitivity and specificity of the new threshold in T2DM patients for PCa screening were 94.53% (vs.91.54%) and 41.36% (vs.46.78%) , area under the curve (AUC) 0.83 (vs.0.83, P>0.5) .

Conclusion: The serum PSA levels in T2DM patients reduced. The new PCa screening threshold in T2DM based on machine learning is 3.27ng/mL. Lowering the PSA screening threshold for T2DM has a better early warning effect on PCa, which is conducive to improving the early diagnosis rate of PCa in T2DM patients.


C.Liu: None. Y.Chen: None. J.Liu: None. J.Yin: None. X.Zha: None. B.Su: None. H.Li: None.

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