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Eight Misconceptions about Prostate-Specific Antigen

Vickers, Andrew J and Lilja, Hans LU orcid (2024) In Clinical Chemistry 70(1). p.13-16
Abstract
Prostate-specific antigen (PSA) was discovered in the 1970s, with assays to detect PSA in blood approved by the US Food and Drug Administration in 1986. Almost from the very beginning, its role as a prostate cancer marker has been severely misunderstood. One of the most well-known misconceptions is that prostate cancer detectable by elevated PSA in asymptomatic men requires treatment, irrespective of stage and grade. Accordingly, when PSA testing to detect prostate cancer began in the United States in the late 1980s and early 1990s, most men with elevated PSA were biopsied and nearly all cancers detected were treated. It is estimated that in its first 20 years of use, PSA screening led to >1 million Americans suffering harm from... (More)
Prostate-specific antigen (PSA) was discovered in the 1970s, with assays to detect PSA in blood approved by the US Food and Drug Administration in 1986. Almost from the very beginning, its role as a prostate cancer marker has been severely misunderstood. One of the most well-known misconceptions is that prostate cancer detectable by elevated PSA in asymptomatic men requires treatment, irrespective of stage and grade. Accordingly, when PSA testing to detect prostate cancer began in the United States in the late 1980s and early 1990s, most men with elevated PSA were biopsied and nearly all cancers detected were treated. It is estimated that in its first 20 years of use, PSA screening led to >1 million Americans suffering harm from radiotherapy or surgery to treat a cancer that would never become apparent before they died of another cause (1).

More than 35 years later, PSA continues to be misunderstood. Here, we try to correct 8 common contemporary misconceptions about PSA. In brief, PSA may have a bad reputation, but it has remarkable properties—when used correctly—that make the clinical biochemistry of prostate cancer the envy of all other solid tumors. (Less)
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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Male, Humans, Prostate-Specific Antigen
in
Clinical Chemistry
volume
70
issue
1
pages
4 pages
publisher
American Association for Clinical Chemistry
external identifiers
  • scopus:85181778139
  • pmid:38175588
ISSN
0009-9147
DOI
10.1093/clinchem/hvad138
language
English
LU publication?
yes
id
85bee133-fe10-495c-901b-79a03b0bf36a
date added to LUP
2024-01-09 09:23:09
date last changed
2024-04-14 03:09:02
@article{85bee133-fe10-495c-901b-79a03b0bf36a,
  abstract     = {{Prostate-specific antigen (PSA) was discovered in the 1970s, with assays to detect PSA in blood approved by the US Food and Drug Administration in 1986. Almost from the very beginning, its role as a prostate cancer marker has been severely misunderstood. One of the most well-known misconceptions is that prostate cancer detectable by elevated PSA in asymptomatic men requires treatment, irrespective of stage and grade. Accordingly, when PSA testing to detect prostate cancer began in the United States in the late 1980s and early 1990s, most men with elevated PSA were biopsied and nearly all cancers detected were treated. It is estimated that in its first 20 years of use, PSA screening led to &gt;1 million Americans suffering harm from radiotherapy or surgery to treat a cancer that would never become apparent before they died of another cause (1).<br/><br/>More than 35 years later, PSA continues to be misunderstood. Here, we try to correct 8 common contemporary misconceptions about PSA. In brief, PSA may have a bad reputation, but it has remarkable properties—when used correctly—that make the clinical biochemistry of prostate cancer the envy of all other solid tumors.}},
  author       = {{Vickers, Andrew J and Lilja, Hans}},
  issn         = {{0009-9147}},
  keywords     = {{Male; Humans; Prostate-Specific Antigen}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{1}},
  pages        = {{13--16}},
  publisher    = {{American Association for Clinical Chemistry}},
  series       = {{Clinical Chemistry}},
  title        = {{Eight Misconceptions about Prostate-Specific Antigen}},
  url          = {{http://dx.doi.org/10.1093/clinchem/hvad138}},
  doi          = {{10.1093/clinchem/hvad138}},
  volume       = {{70}},
  year         = {{2024}},
}