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Five things you need to know about prostate cancer diagnostic tests

(2024) In Asian Journal of Urology
Abstract
For many years, prostate cancer early detection was a straightforward matter of recommending biopsy to all men with an elevated prostate-specific antigen (PSA). This is perhaps best evidenced by the European Randomized Trial of Screening for Prostate Cancer, where an automatic biopsy is specified in the protocol and close to 90% of men with a PSA ≥3.0 ng/mL were biopsied [
1
]. Starting around 2010, concerns about overdiagnosis and overtreatment lead researchers to look at other approaches, leading to the development of numerous blood [
2
], urine [
2
], and imaging [
3
] markers to be used as secondary diagnostic tests. The principle is that although PSA is extremely sensitive for aggressive prostate... (More)
For many years, prostate cancer early detection was a straightforward matter of recommending biopsy to all men with an elevated prostate-specific antigen (PSA). This is perhaps best evidenced by the European Randomized Trial of Screening for Prostate Cancer, where an automatic biopsy is specified in the protocol and close to 90% of men with a PSA ≥3.0 ng/mL were biopsied [
1
]. Starting around 2010, concerns about overdiagnosis and overtreatment lead researchers to look at other approaches, leading to the development of numerous blood [
2
], urine [
2
], and imaging [
3
] markers to be used as secondary diagnostic tests. The principle is that although PSA is extremely sensitive for aggressive prostate cancer—“natural history” study has shown extremely low rates of prostate cancer specific mortality after 20–25-year follow-up in men with PSA levels below the median [
4
]—it has poor specificity, as most men with elevated PSA do not have high-grade disease on biopsy [
1
]. Accordingly, a more specific test is given after an elevated PSA so that the overall pathway has good diagnostic properties. Examples of such tests include the free-to-total PSA ratio, prostate health index, 4Kscore, prostate cancer antigen 3, and MRI. (Less)
Please use this url to cite or link to this publication:
publishing date
type
Contribution to journal
publication status
in press
subject
in
Asian Journal of Urology
editor
Vickers, Andrew J. and LU orcid
publisher
Elsevier
external identifiers
  • scopus:85199437870
ISSN
2214-3882
DOI
10.1016/j.ajur.2024.04.004
language
English
LU publication?
no
id
835120d8-6356-4a4e-9cb1-23bec4447d5c
date added to LUP
2024-08-04 11:57:02
date last changed
2024-08-13 15:00:57
@misc{835120d8-6356-4a4e-9cb1-23bec4447d5c,
  abstract     = {{For many years, prostate cancer early detection was a straightforward matter of recommending biopsy to all men with an elevated prostate-specific antigen (PSA). This is perhaps best evidenced by the European Randomized Trial of Screening for Prostate Cancer, where an automatic biopsy is specified in the protocol and close to 90% of men with a PSA ≥3.0 ng/mL were biopsied [<br/>1<br/>]. Starting around 2010, concerns about overdiagnosis and overtreatment lead researchers to look at other approaches, leading to the development of numerous blood [<br/>2<br/>], urine [<br/>2<br/>], and imaging [<br/>3<br/>] markers to be used as secondary diagnostic tests. The principle is that although PSA is extremely sensitive for aggressive prostate cancer—“natural history” study has shown extremely low rates of prostate cancer specific mortality after 20–25-year follow-up in men with PSA levels below the median [<br/>4<br/>]—it has poor specificity, as most men with elevated PSA do not have high-grade disease on biopsy [<br/>1<br/>]. Accordingly, a more specific test is given after an elevated PSA so that the overall pathway has good diagnostic properties. Examples of such tests include the free-to-total PSA ratio, prostate health index, 4Kscore, prostate cancer antigen 3, and MRI.}},
  editor       = {{Vickers, Andrew J. and Lilja, Hans}},
  issn         = {{2214-3882}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Asian Journal of Urology}},
  title        = {{Five things you need to know about prostate cancer diagnostic tests}},
  url          = {{http://dx.doi.org/10.1016/j.ajur.2024.04.004}},
  doi          = {{10.1016/j.ajur.2024.04.004}},
  year         = {{2024}},
}