Repeat PSA Tests May Aid Prostate Biopsy Decisions

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Eur Urol. 2008;53:777-784

 

Following an initial PSA test result of 3.0-19.99 ng/mL in men aged 50-70 years, a repeat PSA test within seven weeks allows for more accurate assessment as to whether a biopsy will reveal prostate cancer, a British team reports.

 

Derek J. Rosario, MD, of the University of Sheffield, J. Athene Lane, PhD, of the University of Bristol, and colleagues studied  4,102 men who had initial PSA readings of 3.0-19.99 ng/mL and had a repeat PSA test (median interval of 50 days) followed by prostate biopsy. The biopsy decision was based on the first PSA level.

 

Men who had a 20% drop in PSA level had a 57% lower risk of prostate cancer and a 71% lower risk of high-grade cancer compared with the rest of the cohort. The effect of percentage reduction was greater among men aged 60 years and younger than in those older than 60 years.

 

Among men aged 60 years and younger, the 20% drop in PSA translated into a risk reduction of high-grade malignancy from 4% to 0.5%, 6% to 2%, and 15% to 2% when the initial PSA measurement was 3.0-3.99, 4.0-5.99, and 6 ng/mL or higher.

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