Navigation Links
Biopsy techniques have made PSA test less predictive
Date:3/9/2008

Prostate specific antigen (PSA) levels typically have correlated with prostate biopsy results in the detection of prostate cancer, but that correlation no longer exists for men with a normal prostate exam, according to a new study published in the April 15, 2008 issue of CANCER, a peer-reviewed journal of the American Cancer Society. The study suggests that improved biopsy techniques make PSA less useful in prostate cancer screening.

PSA tests have been lauded as important diagnostic tools for prostate cancer, however much of the data used to make this conclusion were generated in the early to mid 1990s, when prostate biopsies were performed differently than they are today. Since that time, there has been an increase in the number of prostate biopsies performed and an increasing number of biopsy samples taken from each patient.

Douglas Scherr, MD, Michael Schwartz, MD, and colleagues at the New York Presbyterian Hospital of the Weill Medical College of Cornell University, in New York City, set out to assess whether changes in prostate biopsy practices might have changed the predictive value of PSA tests.

The researchers performed a retrospective analysis of all prostate biopsies performed at their institution between 1993 and 2005, finding 1,607 that satisfied their inclusion and exclusion criteria. Douglas Scherr, MD and his team divided patients into three groups based on when they received their biopsies: 1993-1997, 1998-2001, and 2002-2005. They examined each group for the number of biopsies performed, the number of positive biopsies, patient age, most recent PSA prior to biopsy, prostate volume, and number of biopsy samples taken. With these data in hand, they assessed potential correlations between PSA levels and positive biopsy rate.

The investigators found that the number of biopsies performed, the percentage of positive biopsies, and patient ages did not change significantly over time. However, there was a significant decrease in the median PSA level in patients undergoing biopsy and an increase in the median number of samples taken at the time of biopsy. Also, fewer biopsies were performed for the indication of a suspicious digital rectal exam and there was an increase in the percentage of patients undergoing biopsy for PSA readings between 2.5 and 3.99 ng/ml. (According to the American Cancer Society, the PSA level usually goes above 4 ng/ml when prostate cancer develops, but about 15% of men with a PSA below 4 ng/ml will have prostate cancer on biopsy.)

The positive biopsy rate in men with PSA levels in the 2.0 to 3.99 ng/ml range equaled or surpassed that for patients with higher PSA readings. Therefore, the researchers concluded that the correlation between PSA and positive biopsy rate no longer holds true in our patient population for men with a normal digital rectal exam and PSA 2.0 ng/ml.

While changes in biopsy practice patterns have improved cancer detection, these very changes have negatively influenced the predictive value of PSA in men with a normal digital rectal exam such that, using current biopsy practice patterns, PSA no longer correlates with positive biopsy rate, note the authors. They cite the urgent need for new blood or urinary markers to better determine who needs a prostate biopsy, adding that aside from family history or prior atypical biopsy findings, there is little other information available to help physicians decide who needs a biopsy and who does not.


'/>"/>

Contact: Amy Molnar
amolnar@wiley.com
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Less invasive lymph node biopsy method could spare thousands unnecessary operations
2. Noninvasive tests for cirrhosis may help to avoid liver biopsy
3. Study Supports Change to Prostate Cancer Biopsy
4. Using additional biopsy-scoring data may help determine prostate cancer prognosis
5. Through-Wave Ultrasound: Effective, Economical and Ideal for Breast Imaging, Biopsy
6. Virtual biopsy cuts out need for diagnostic surgery
7. The Pharma & Life Sciences Best Practice Database: an Industry Resource for Successful Techniques and Performance Benchmarks for Reaching the Top
8. Exploring the Use of Techniques From Neuroscience in Todays Marketing
9. MRI techniques evolving towards better assessment of liver fibrosis
10. Improved diagnosis of cutaneous leishmaniasis thanks to new techniques
11. New Technology and Improved Techniques Arm Dermatologists With Tools to Minimize Facial Scars From Skin Cancer Surgery
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2017)... ... June 25, 2017 , ... An increase in wetter weather in ... plants, and along with that; a humdinger of an allergy season. A relief from ... an increase in misery-causing grass and weed pollen. , “Our patients have been ...
(Date:6/25/2017)... ... 25, 2017 , ... With a heatwave currently bearing down on Northern California pushing temperatures to ... Being swimsuit ready is easy with laser hair removal. , The process of summer ... burdensome routine when all you want to do is get out, dive in and cool ...
(Date:6/24/2017)... Tampa, Fla. (PRWEB) , ... June 24, 2017 ... ... Fla., is now offering genetic testing for medications in select Florida and Texas ... of pharmacogenomics. , This new application of genetic testing recognizes the role ...
(Date:6/24/2017)... Ronkonkoma, New York (PRWEB) , ... June 24, ... ... now joined the Dental365 family. Located at 217 Portion Road in Lake Ronkonkoma, ... also open evenings and weekends so that visits to the dentist fit into ...
(Date:6/24/2017)... ... 24, 2017 , ... Doorknobs are for convenience, deadbolts are for security. , ... dog or having an alarm system installed. But unless there is a working deadbolt ... owner of TX Premier Locksmith in Killeen, TX says: “In the majority of home ...
Breaking Medicine News(10 mins):
(Date:6/9/2017)... BRUSSELS and INDIANAPOLIS , ... people are living with diabetes. In a further effort ... benefit people affected by this condition, the International Diabetes ... LLY ) have come together for the second ... Environments and Systems programme (BRIDGES 2), reaffirming their commitment ...
(Date:6/7/2017)... , June 7, 2017  Novavax, Inc., (Nasdaq: ... two Phase 2 trials of its RSV F protein recombinant ... bearing age have been published in the journal ... been shared in prior scientific conferences). The Company previously announced ... 2014. Novavax is developing the RSV F Vaccine with the ...
(Date:6/2/2017)... , June 2, 2017  NxStage Medical, Inc. (Nasdaq: ... care, today announced new findings demonstrating positive biochemical outcomes ... System One™. The data will be presented at ... Madrid, Spain . ... Improve Home Dialysis Network in Europe ...
Breaking Medicine Technology: