prostate-report.org

Early prostate-specific antigen changes and the diagnosis and prognosis of prostate cancer.

Researchers at Department of Clinical Laboratories, Memorial Sloan-Kettering Cancer Center, New York, have reviewed current applications of PSA-related data to improve prediction of risk, detection, and prediction of clinical endpoints of prostate cancer treatments.

They note that no specific PSA cut-point (e.g, 2.5 or 4.0 ng/ml) achieves both high sensitivity and high specificity; that the accuracy of prostate cancer detection can be increased by additional predictive factors and a combinations of markers; that a panel of kalikrein markers can be used to increase the specificity of PSA testing, and reduces costs by eliminating unnecessary biopsies; that large, population-based studies have shown that PSA can be used to predict prostate cancer risk many years in advance; but that there is no definitive evidence that PSA screening lowers prostate cancer-specific or overall mortality. They suggest that statistical prediction models and the integration additional markers with PSA data may be able to improve and individualize prostate cancer diagnostic and prognostic information.

They also point out, again, that a single PSA measurement at early middle age can predict risk for advanced prostate cancer decades in advance, and stratify patients for intensity of subsequent screening.