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Researchers look at early analysis of PSA, universal cut-off for PSA testing

Monday, May 16, 2011 (Last Updated: 05/17/2011)

MONDAY, May 16 (HealthDay News) -- Optimizing the use of prostate-specific antigen (PSA) testing may help to better identify patients with prostate cancer and improve outcomes, according to research presented at the annual meeting of the American Urological Association, held from May 14 to 19 in Washington, D.C.

Andrew Vickers, M.D., of the Memorial Sloan Kettering Cancer Center in New York City, and colleagues identified 141 men in the Preventive Project study who had subsequently died of prostate cancer. The investigators found that 44 percent of the deaths occurred in men whose PSA score fell in the top 10 percent (≥1.5 ng/mL). The investigators expanded their analysis to the top quartile of men and measured free PSA and human glandular kallikrein 2, demonstrating that these markers helped to identify an additional 2.4 percent of deaths in the top 10 percent of risk.

In another study, Stacy Loeb, M.D., of Johns Hopkins University School of Medicine in Baltimore, and colleagues identified 448 men between the ages of 60 and 70 with PSA measurements, including 199 with a PSA below 1 ng/mL. They used data from the Baltimore Longitudinal Study of Aging. Among the 199 men with low PSA, the investigators found that 13 were later diagnosed with prostate cancer, including four with significant disease. Therefore, the investigators concluded that applying a universal cut-off point for PSA may not be advisable. Another study evaluated the utility of PSA velocity (PSAV) for detection of prostate cancer and found that PSA should be closely followed even if a patient's initial biopsy was negative. A fourth study suggested that PSAV and its rate of increase over time may be a key marker in identifying aggressive prostate cancer.

"Debate has been ongoing about the use of the PSA test in the detection of prostate cancer but the question may not be whether we use the test but, rather, how we use it," Christopher Amling, M.D., of the Oregon Health and Science University in Portland, who moderated a press briefing on the research, said in a statement. "These studies shed important light on how we might refine our use and interpretation of the PSA test."

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Specialties Hematology & Oncology
Internal Medicine
Pathology
Family Practice
Geriatrics

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