Should percent free PSA be used in the decision to perform initial prostate biopsy in men with moderately elevated PSA?

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A recently published paper in Urology (2011;78:392-398) by investigators at Cleveland Clinic's Glickman Urological and Kidney Institute reported on the development of an improved nomogram for predicting outcomes of initial biopsies based on readily available clinical information. This information includes six risk factors: age, race, PSA, percent free PSA, family history of prostate cancer, and digital rectal examination findings. The nomogram was developed based on a study of 1,551 men with a PSA level of 10 ng/mL or lower undergoing initial prostate biopsy.

All six risk factors predicted PCa, but Renal & Urology News would like to ask urologists the following question.


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