Friday, October 7, 2011

From NYU: Baseline PSA testing at a "young" age?

http://www.ncbi.nlm.nih.gov/pubmed/21862205

Eur Urol. 2011 Aug 10. [Epub ahead of print]
Baseline Prostate-Specific Antigen Testing at a Young Age.
Loeb S, Carter HB, Catalona WJ, Moul JW, Schroder FH.
Source
Department of Urology, New York University School of Medicine, New York, NY, USA.
Abstract
CONTEXT:
Prostate cancer screening is highly controversial, including the age to begin prostate-specific antigen (PSA) testing. Several studies have evaluated the usefulness of baseline PSA measurements at a young age.

OBJECTIVE:
Review the literature on baseline PSA testing at a young age (≤60 yr) for the prediction of prostate cancer risk and prognosis.

EVIDENCE ACQUISITION:
PubMed was searched for English-language publications on baseline PSA and prostate cancer for the period ending April 2011.

EVIDENCE SYNTHESIS:
In most published series, median PSA levels in the general male population range from approximately 0.4 to 0.7 ng/ml in men in their 40s and from approximately 0.7 to 1.0 ng/ml in men in their 50s. Evidence from both nonscreening and screening populations has demonstrated the predictive value of a single baseline PSA measurement for prostate cancer risk assessment. Specifically, men with baseline PSA levels above the age-group-specific median have a greater risk of prostate cancer diagnosis during the next 20-25 yr. Additional studies confirmed that higher baseline PSA levels at a young age are also associated with a greater risk of aggressive disease, metastasis, and disease-specific mortality many years later.

CONCLUSIONS:
Baseline PSA measurements at a young age are significant predictors of later prostate cancer diagnosis and disease-specific outcomes. Thus baseline PSA testing may be used for risk stratification and to guide screening protocols.

Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

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