Prostate news article, August 2004
| PROSTATE SPECIFIC
ANTIGEN (PSA) AS A SCREENING TEST FOR PROSTATE CANCER
Professor Roger S Kirby St George's Hospital. London |
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Prostate specific antigen testing for prostate cancer has recently been the subject of controversy and some criticism. Quite correctly, it has been pointed out that as yet there is no definitive evidence that early detection of prostate cancer by PSA testing actually reduces the risk of death from prostate cancer. The trials to determine this are underway but the results are not expected until 2008 at the earliest.
In the July 2004 Journal of Urology, Antenor et al (J Urol 172:90-93, 2004) report a longitudinal study of 26,111 men of PSA testing combined with digital rectal examination (DRE) of the prostate.
Their results confirm those of other investigators that the initial PSA value was strongly associated with the subsequent detection of prostate cancer, as well as with the stage and grade of the cancer at the time of diagnosis.
The results are summarised in a table:
| Initial PSA Value (ng/ml) | Relative Risk of Prostate Cancer |
| 0.0 -1.0 | 1.0 |
| 1.0 - 1.5 | 4.3 |
| 1.5 - 2.0 | 8.8 |
| 2.0 - 3.0 | 14.9 |
| 3.0 - 4.0 | 23.3 |
| 4.0 - 10.0 | 38.7 |
| Greater than 10.0 | 104.2 |
This study confirms that PSA screening is capable not only of detecting men that harbour prostate cancer at the time of testing, but also can predict those who are at increased risk of developing prostate cancer at a subsequent time point.