Prostate Cancer - PSA

Prostate cancer is the most frequent malignant neoplasm in men and the second most common cancer to cause death among American men.  The disease ranges from indolent malignancies, which may not need treatment, to more aggressive forms that should be treated.  Current recommendations aim to guide clinicians and patients toward a balanced and individualized approach to screening to avoid unnecessary treatment while enabling early detection of aggressive prostate cancers.   Such an approach to screening is especially important because of the harms associated with screening, such as false-positive results and consequent additional tests or biopsies, psychological distress, overdiagnosis, overtreatment, and adverse effects of treatment.  Laboratory testing involves serum prostate-specific antigen (PSA) testing, PSA derivatives, and other biomarkers. Digital rectal examination (DRE) is not recommended for use as a standalone test but should be considered in conjunction with PSA results in men who have chosen to undergo screening for early detection of prostate cancer.  Percent free PSA, PSA velocity, and PCA3, and calculations such as the Prostate Health Index (PHI), are useful for risk stratification. In addition to PSA, tests that may be useful for monitoring patients after diagnosis include circulating tumor cell (CTC) count  and complexed PSA (cPSA) tests.

Tabs Content
Content Review: 
March 2019

Last Update: March 2019