The 10 Great Foibles of PSA Testing
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This special report was stimulated in part by two recent reports, denoting changes in prostate cancer over the past 2 decades and helping to establish certain limitations on the current use of PSA testing. The 2 pivotal articles are: T. A. Stamey, et al.The Prostate Specific Antigen Era in the U.S. is Over for Prostate Cancer: What Happened in the Last 20 Years J.Urol. 172: 1297, 2004. Conclusion: Serum PSA levels are no longer related to prostate cancer, but only to the volume of BPH present. There is an urgent need for a better serum marker! I. M. Thompson, et al.Operating Characteristics of Prostate-Specific Antigen in Men with an Initial PSA Level of 3.0 ng/ml or Lower. JAMA 294:66, 2005. Conclusion: There is no cutpoint of PSA with simultaneous high sensitivity and high specificity for monitoring healthy men for prostate cancer, but rather a continuum of prostate cancer risk at all values of PSA. |
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