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PSA testing, combined with other relevant patient data can reduce unnecessary prostate biopsies
Date:12/8/2011

by adjusting PSA results for other considerations such as family history, obesity, and prostate size.

Results from the multi-center study that suggest that PSAD levels of less than 0.1 in contrast to the unadjusted level of between 2.5 and 4 can be a better benchmark of a potential cancer. The density, determined by a digital rectal exam, enables physicians to take into account other factors like benign prostatic hyperplasia, an enlargement of the gland that affects all men as they age.

Combining the PSAD with the digital exam, a look at the patient's family history and a body mass index of 25 of less the calculation used to define obesity would avoid biopsy in approximately one-quarter of biopsy-eligible men, the researchers found.

"Urological practice, patient outcome and cost-effectiveness of health care would each benefit from new targeted strategies, such as nomograms (a predictive tool) that improve prediction of aggressive cancers, to enable selective identification of candidate for prostate biopsy that would improve the yield of clinically significant, histologically aggressive cancers warranting subsequent definitive treatment," researchers wrote.

In a separate multicenter study published in Urologic Oncology, researchers said a test looking for two specific genetic biomarkers TMPRSS2:ERG and PCA3 taken after a digital rectal exam, could help limit biopsies to men who possess both genes and whose PSA readings range between 2 and 10, potentially sparing one-third of men from biopsies.

"Urine testing for prostate cancer is in its infancy," says Sanda, noting next steps are underway as a result of study funded by a $3.1 million grant from the National Institutes of Health , that is evaluating new urine and blood test for prostate cancer in more 2,400 men over the next five years with a goal of improving upon the problems of over-diagnosis and over-treatment.

A focal point of the proposed work involves
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Contact: Jerry Berger
jberger@bidmc.harvard.edu
617-667-7308
Beth Israel Deaconess Medical Center
Source:Eurekalert

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