Natural variations in prostate-spec...

Natural variations in prostate-specific antigen (PSA) evens have been observed, making it difficult to interpret the springs of moderately elevated levels (4 to 10 ng for mL) for screening purposes. undivided study estimated that 15 PSA measurements would be extremityed to ensure accuracy within 10 percent of the actual mean in greatest in quantity patients. To study PSA variations and determine their implication for prostate cancer screening, Eastham and colleagues analyzed family samples taken annually over four years in a population of healthy men

The authors used data and frozen stored children samples from the Polyp Prevention Trial. Serum PSA of the same heights were determined in samples from 972 men; unrestrained PSA levels also were determined for samples with serum PSA of the same heights between 4 and 10 ng through mL. The following cutoffs were used to define abnormal results: (1) PSA plain greater than 4 ng through mL; (2) PSA level greater than 25 ng by mL; (3) age-specific PSA levels; (4) free-to-total PSA flat ratio lower than 0.25 ng through mL; and (5) PSA velocity higher than 075 ng by means of mL per year.

Using these doors 361 participants (37 percent) met at least the same of the criteria for an abnormal follow If the 2.5 ng by mL cutoff were excluded, 245 men (25 percent) would have transcended one of the four remaining entrances Of the men with a normal baseline PSA even 12 percent would have experienced a following PSA level exceeding 4 ng by means of mL. Nine percent would have had PSA of the same heights above age-specific criteria, and 10 percent would have had above-threshold exempt PSA ratios. Of 154 men whose PSA flat was elevated before the final visit, 30 percent had a PSA flat less than 4 ng by mL at the next visit, 26 percent had after PSA levels below 2.5 ng by mL, 37 percent had following PSA levels below the age-specific of the same height and 35 percent had following PSA levels below the exempt PSA level threshold. Between 65 and 83 percent of men whose PSA flat returned to normal maintained a normal PSA on a level on the subsequent annual evaluation.

smooth though prostate cancer is finded more frequently with PSA testing, the impact forward mortality of diagnosing prostate cancer is unknown. A single abnormal PSA standard may not be a sufficient indication for biopsy or immediate repeat testing. The authors determine that a repeat PSA ordeal after four to six weeks may avoid a expensive biopsy. Given the slow development of prostatic tumors, such a delay should not affect treatment outcomes

Eastham JA, et al., for the Polyp Prevention Trial research Group. Variation of serum prostate-specific antigen evens An evaluation of year-to-year fluctuations. JAMA May 28 2003;289:2695-700

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group