Prostate-specific antigen: improving its ability to diagnose early prostate cancer

Article Abstract:

Measurement of blood levels of prostate-specific antigen (PSA) may be an effective method to identify men with early prostate cancer. Many physicians are interested in detecting prostate cancer before it spreads to other parts of the body. Several research studies have found that patients with early localized prostate cancer who did not receive treatment may have a high survival rate. But another study found that prostate gland patients who did not receive treatment had a higher risk of dying, compared with patients who were treated. Two studies found that measurement of blood levels of PSA may detect one-third of the cases of prostate cancer that are not detected using digital rectal examination (DRE). Measurement of PSA should not be used alone to diagnose prostate cancer. PSA measurement may miss some cancer and increased blood levels of PSA may indicate other prostate diseases. Measuring PSA levels over time may be more useful for detecting early prostate cancer than a single PSA measurement. Older men should have their PSA levels measured and undergo a DRE every year to screen for prostate cancer.

Editorial, Tissue specific antigens

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The use of prostate-specific antigen in staging patients with newly diagnosed prostate cancer

Article Abstract:

Men with newly-diagnosed prostate cancer who have no bone pain and a prostate-specific antigen (PSA) concentration of 10 micrograms per liter (micrograms/l) or less probably have not had the cancer spread into their bones. They could safely forgo a radionuclide bone scan. In a survey of the medical records of 852 men with newly-diagnosed disease and a PSA level of 20 micrograms/l or less, only seven had a positive bone scan indicating possible skeletal metastases. None of the 467 men with PSA levels of eight micrograms/l or less had positive bone scans. PSA levels were confirmed to be the best predictor of a positive bone scan. The average cost of a bone scan in the US is $600. A sample of 221 men with newly-diagnosed prostate cancer found that 40% had PSA levels of 10 micrograms/l or less. Millions of dollars could be saved if these men were not given bone scans.

Measurement, Tumor antigens, Radionuclide imaging, Radioisotope scanning

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Serum prostate-specific antigen in a community-based population of healthy men: establishment of age-specific reference ranges

Article Abstract:

Blood levels of prostate-specific antigen (PSA) and prostate gland volume may increase with patient age. Measurement of blood levels of PSA is a method used to screen healthy men for prostate cancer. Researchers examined the association between blood levels of PSA, prostate gland volume and patient age in 471 healthy men between 40 and 79 years old. Older men had higher blood levels of PSA than younger men. Blood levels of PSA rose with each decade of life. Prostate gland volume also increased with patient age. A set of age-specific reference ranges for PSA concentration may improve the effectiveness of this measurement for detecting prostate cancer.

Usage, Medical screening, Health screening

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