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Results of Prostate Cancer Test Interpreted in New Way
The prostate-specific antigen (PSA) test used to screen men for prostate cancer is being interpreted somewhat differently by many physicians as a result of recent studies suggesting that more important than absolute values of PSA is the rate of change in a person’s PSA over time.
“It has become apparent in the last several years that PSA kinetics give us
much better information about whether 
there is likely to be cancer present, and whether
that cancer is likely to be aggressive,” says UCLA urologist Mark Litwin, M.D.,
M.P.H. He explains that a patient with a PSA of 6.5—well above the range where
cancer is typically suspected—might not need a biopsy if that level has remained
flat from one year to the next, whereas a man whose PSA has climbed from 1 to 3
in a year’s time would be a strong candidate for biopsy, despite a PSA level
generally defined as normal. This new diagnostic approach applies to men who
have already been treated for prostate cancer and are being monitored for
potential recurrence, as well as men who have never been diagnosed, Dr. Litwin
notes.
For most men, annual PSA tests are recommended from age 50 to 70, with African Americans and men who have had a father or brother with prostate cancer advised to begin at age 45. Given the evidence suggesting the value in comparing PSA scores over time, those who pursue PSA screening should do so annually, Dr. Litwin says.
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