Clinicians screen for prostate specific antigen (PSA) with the goal of identifying
localized disease before it becomes systemic and kills the patient. Only a prostate
biopsy can confirm the suspicion of prostate cancer raised by an elevated PSA. When
first proposed as a screening test in 1991, the cut point was set at 4 ng/mL.
1
Unfortunately, controversy surrounding this practice has raged for the past three
decades. Urologists often proceed with a prostate biopsy when values cross 3 ng/mL
out of fear of missing clinically significant disease. The US Preventive Task Force
advises against PSA testing at any threshold because a majority of men have negative
biopsies or are found to have clinically insignificant disease.
2
Optimal practice lies somewhere in between.To read this article in full you will need to make a payment
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References
- Measurement of prostate-specific antigen in serum as a screening test for prostate cancer.N Eng J Med. 1991; 324: 1156-1161
- Screening for prostate cancer: US Preventive services task force recommendation statement.Ann Intern Med. 2012; 157: 120-134
- Reconsidering prostate cancer mortality – The future of PSA screening.N Eng J Med. 2020; 382: 1557-1563
Article info
Publication history
Accepted:
May 5,
2021
Received:
January 20,
2021
Identification
Copyright
© 2021 Published by Elsevier Inc.
