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)
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https://lup.lub.lu.se/record/835120d8-6356-4a4e-9cb1-23bec4447d5c
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- in press
- subject
- in
- Asian Journal of Urology
- editor
- Vickers, Andrew J. and Lilja, Hans LU
- 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}}, }