Featured Research

from universities, journals, and other organizations

Change in PSA level does not predict prostate cancer, study finds

Date:
February 25, 2011
Source:
Memorial Sloan-Kettering Cancer Center
Summary:
Researchers have found that change in PSA levels over time -- known as PSA velocity -- is a poor predictor of prostate cancer and may lead to many unnecessary biopsies.

Researchers at Memorial Sloan-Kettering Cancer Center have found that change in PSA levels over time -- known as PSA velocity -- is a poor predictor of prostate cancer and may lead to many unnecessary biopsies.

The new study of more than 5,000 men was published online February 24 in the Journal of the National Cancer Institute. Andrew Vickers, PhD, Associate Attending Research Methodologist in the Department of Epidemiology and Biostatistics and lead author said, "We have found no evidence to support the recommendation that men with a high PSA velocity should be biopsied in the absence of other indications. In other words, if a man's PSA has risen rapidly in recent years, there is no cause for concern if his total PSA level is still low and his clinical exam is normal."

Prostate cancer is the most common cancer among American men and the second leading cause of cancer deaths in men, according to the American Cancer Society. While PSA screening is widely used for the early detection of prostate cancer, it is also associated with a high rate of overdiagnosis, which can lead to unnecessary treatment and anxiety. Currently, early detection guidelines of several organizations (the National Cancer Center Network and the American Urological Association) recommend that men with a rapid rise in PSA -- or a high PSA velocity -- have a surgical biopsy for prostate cancer, even if there are no other indicators that cancer may exist. Those indicators could be an elevated baseline PSA or a positive digital rectal exam (DRE).

This study's population came from the Prostate Cancer Prevention Trial. Five thousand five hundred and nineteen men aged 55 years and older with no previous prostate cancer diagnosis, normal DRE, and a baseline PSA of 3.0 ng/mL or less were randomly assigned to finasteride -- a drug commonly used to treat enlargement of the prostate gland, more commonly referred to as BPH, or benign prostatic hypertrophy -- or placebo for seven years. This particular study focused on the men in the placebo group. The men were followed with yearly PSA tests, with biopsy recommended for men with a PSA higher than 4.0 ng/mL. After seven years, all men who were not diagnosed with prostate cancer were asked to consent to an end-of-study biopsy.

Dr. Vickers and colleagues found no important association between PSA velocity and biopsy outcome after adjusting for risk factors such as age, race, and PSA levels. PSA alone was a much better predictor of biopsy outcome than PSA velocity.

According to Peter T. Scardino, MD, Chair of the Department of Surgery, "This study should change practice. We have previously published papers determining that PSA naturally varies from month to month and have urged men whose PSA suddenly rises to wait six weeks and repeat the test before agreeing to a needle biopsy. This new study in a large population of men provides even stronger evidence that using changes in PSA as a basis for recommendation for biopsy leads to many more unnecessary biopsies and does not help to find the more aggressive cancers that we want to find and treat." Dr. Scardino added that "men should be cautious before rushing into a biopsy for minor variations in their PSA level."

The work was funded by the Prostate Cancer Foundation, the Sidney Kimmel Center for Prostate and Urologic Cancers, and a P50-CA92629 SPORE grant from the National Cancer Institute to Dr. Scardino. Additional support was obtained from the National Institutes of Health.


Story Source:

The above story is based on materials provided by Memorial Sloan-Kettering Cancer Center. Note: Materials may be edited for content and length.


Journal Reference:

  1. Andrew J. Vickers, Cathee Till, Catherine M. Tangen, Hans Lilja and Ian M. Thompson. An Empirical Evaluation of Guidelines on Prostate-specific Antigen Velocity in Prostate Cancer Detection. J Natl Cancer Inst, February 24, 2011 DOI: 10.1093/jnci/djr028

Cite This Page:

Memorial Sloan-Kettering Cancer Center. "Change in PSA level does not predict prostate cancer, study finds." ScienceDaily. ScienceDaily, 25 February 2011. <www.sciencedaily.com/releases/2011/02/110224161505.htm>.
Memorial Sloan-Kettering Cancer Center. (2011, February 25). Change in PSA level does not predict prostate cancer, study finds. ScienceDaily. Retrieved September 1, 2014 from www.sciencedaily.com/releases/2011/02/110224161505.htm
Memorial Sloan-Kettering Cancer Center. "Change in PSA level does not predict prostate cancer, study finds." ScienceDaily. www.sciencedaily.com/releases/2011/02/110224161505.htm (accessed September 1, 2014).

Share This




More Health & Medicine News

Monday, September 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Get on Your Bike! London Cycling Popularity Soars Despite Danger

Get on Your Bike! London Cycling Popularity Soars Despite Danger

AFP (Sep. 1, 2014) Wedged between buses, lorries and cars, cycling in London isn't for the faint hearted. Nevertheless the number of people choosing to bike in the British capital has doubled over the past 15 years. Duration: 02:27 Video provided by AFP
Powered by NewsLook.com
We've Got Mites Living In Our Faces And So Do You

We've Got Mites Living In Our Faces And So Do You

Newsy (Aug. 30, 2014) A new study suggests 100 percent of adult humans (those over 18 years of age) have Demodex mites living in their faces. Video provided by Newsy
Powered by NewsLook.com
Liberia Continues Fight Against Ebola

Liberia Continues Fight Against Ebola

AFP (Aug. 30, 2014) Authorities in Liberia try to stem the spread of the Ebola epidemic by raising awareness and setting up sanitation units for people to wash their hands. Duration: 00:41 Video provided by AFP
Powered by NewsLook.com
California Passes 'yes-Means-Yes' Campus Sexual Assault Bill

California Passes 'yes-Means-Yes' Campus Sexual Assault Bill

Reuters - US Online Video (Aug. 30, 2014) California lawmakers pass a bill requiring universities to adopt "affirmative consent" language in their definitions of consensual sex, part of a nationwide drive to curb sexual assault on campuses. Linda So reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins