PSA score of 3.0 ng/mL is likely appropriate minimum cut-off to indicate biopsy needed
Wednesday, February 16, 2011 (Last Updated: 02/17/2011)
WEDNESDAY, Feb. 16 (HealthDay News) -- An initial prostate-specific antigen (PSA) score of 3.0 ng/mL among men appears to be an appropriate minimum cut-off level to indicate that biopsy should be performed, according to research being presented at the 2011 Genitourinary Cancers Symposium, held from Feb. 17 to 19 in Orlando, Fla.
As part of the larger European Randomized Study of Screening for Prostate Cancer, Meelan Bul, M.D., of the Erasmus University Medical Center in Rotterdam, Netherlands, and colleagues analyzed both incidence of and deaths from prostate cancer among 42,376 men between the ages of 55 and 74 years, randomizing them to screening or a control arm.
The investigators found that 15,758 (79 percent) of the men had an initial PSA under 3.0. Over a median follow-up of 11 years, 915 of those men (5.8 percent) were diagnosed with prostate cancer, with only 23 deaths. Of the 915 diagnosed with prostate cancer, 182 were detected between screenings, often indicating a faster-moving disease; 169 (1.1 percent) were determined to have aggressive prostate cancer. Prostate cancer incidence and deaths increased significantly with higher PSA levels.
"We now know more about prostate cancer detected by PSA screening in men with initial PSA scores of less than 3.0," Bul said in a statement. "Our results strengthen the justification of the use of PSA in risk stratification for screening purposes. This means that we can possibly avoid unnecessary testing, diagnosis and treatment of less aggressive disease, with the accompanying side effects, by focusing biopsies and other follow-up on men with higher initial PSAs above 3.0."
Two study authors disclosed consultant or advisory roles with GlaxoSmithKline; one of these authors also disclosed roles with Bechman Coulter and Gen-Probe.
Hematology & Oncology
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