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PSA Test Cut-off Could Signal Low-Risk Prostate Cancer
Date:2/16/2011

By Amanda Gardner
HealthDay Reporter

TUESDAY, Feb. 15 (HealthDay News) -- Men who have a low prostate-specific antigen (PSA) score when they're first tested may not need to be screened annually and probably don't need to undergo a biopsy, a new study suggests.

Dutch researchers presenting the findings at the Genitourinary Cancers Symposium in Orlando, Fla., said that few men with a PSA below 3.0 ng/ml were likely to develop prostate cancer and die of the disease.

"PSA can identify those at low risk of prostate cancer and once you have done that, you can remove almost 50 percent of men in the age group 55 to 74 [from undergoing biopsies]," said study senior author Monique Roobol, an epidemiologist in the department of urology at Erasmus University Medical Center in Rotterdam.

For this study, about 20,000 men aged 55 to 74 in the Rotterdam area were screened, with those having PSA scores at or above the cut-off of 3.0 sent for biopsies and additional screenings every four years. Eighty percent of men in the group had PSA levels below that threshold.

In this group of men, the higher the PSA level at baseline, the more likely the person was to develop prostate cancer and to die of the disease. Only 1.8 percent of men with PSA scores below 1.0 were diagnosed with prostate cancer, with only 0.04 percent dying of the disease. This compares with 15.7 percent of those with scores from 2 percent to 2.9 percent developing a malignancy and 0.36 percent dying of the disease.

"This gives us some confidence that annual PSA screening is going to soon become a thing of the past," said Dr. Nicholas J. Vogelzang, chair of the Developmental Therapeutics Committee of US Oncology, who moderated the teleconference. "A low PSA, particularly those in men who have less than 1.0, and probably those less than 2.0, certainly could be considered for substantially longer intervals of PSA screening... Personalization of PSA screen
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