Navigation Links
PSA velocity screening for prostate cancer may lead to unnecessary biopsies
Date:2/24/2011

Guidelines of several cancer organizations have recommended that men with a rapid rise in PSA have a biopsy for prostate cancer, even if there is no other indication and the PSA is within the "normal" range. But change in PSA known as PSA velocityis a poor predictor of prostate cancer, and may lead to many unnecessary biopsies, according to a study published online February 24 in the Journal of the National Cancer Institute.

Researchers have known for many years that PSA velocity is statistically correlated with prostate cancer risk. But little is known about how much PSA velocity adds to the value of other indicators or how useful it is to men and their physicians in making decisions about biopsies. And there has never been a study of PSA velocity in men who have had biopsies in the absence of a high PSA or a positive digital rectal exam.

Andrew Vickers, Ph.D., at Memorial Sloan-Kettering Cancer Center, and colleagues assessed how well PSA velocity predicted cancer (positive biopsy results) in 5,519 men who took part in the Prostate Cancer Prevention Trial. The men in this analysis were all in the group that received a placebo, so their prostate cancer risk was not influenced by the drug finasteride (Proscar), which was tested in that trial. All had a biopsy at the end of the study, regardless of their PSA levels, PSA velocity, or other indicators.

As expected, the authors found a statistical association between PSA velocity and biopsy outcome. But when they adjusted for other risk indicators, such as age, race, PSA levels, and digital rectal exam, there was virtually no association between PSA velocity and biopsy outcome.

"There was little evidence that PSA velocity adds an important level of predictive accuracy to either standard predictors or to PSA alone," they write.

The authors also evaluated guidelines stating that men with a rapid rise in PSA should have a biopsy even if their PSA is low and there are no abnormal findings on a clinical exam. The vast majority of the men who fell into this category (about 80%) did not have cancer, suggesting that use of PSA velocity would lead to many unnecessary biopsies. PSA alone was a better predictor of biopsy outcome in these men than PSA velocity.

"In other words," they write, "if a clinician feels that the current PSA thresholds are insufficiently sensitive, he or she would be better off identifying patients to biopsy by using low PSA thresholds than by adding PSA velocity as a criterion for biopsy."

The authors conclude that PSA velocity should not be included in prostate cancer screening guidelines.

In an accompanying editorial, Siu-Long Yao, M.D., and Grace Lu-Yao, Ph.D., of the Cancer Institute of New Jersey agree that the findings suggest that PSA velocity does not help doctors and patients decide what to do about screening results.

"PSA velocity measurements take time to acquire, and recognizing that such data add relatively little information may help prevent inappropriate postponement of follow-up in affected patients," they write. "Avoiding the wait to acquire subsequent PSA values may also help reduce some of the anxiety associated with testing." They go on to say that the results of this study serve to "remind us that the use of PSA as a screening tool still leaves much to be desired."


'/>"/>

Contact: Caroline McNeil
Caroline.McNeil@oup.com
301-841-1286
Journal of the National Cancer Institute
Source:Eurekalert

Related medicine news :

1. ATV and motocross sports - high velocity toys merit caution
2. Abatement Technologies Announces High-Velocity RAPTOR™ Air Movers for Water Damage Restoration Contractors
3. PSA Screening for Prostate Cancer Dips in Large U.S. Health Network
4. Screening mammograms catch second breast cancers early
5. Higher volume reduces false positives in screening mammography
6. Worlds largest lung cancer screening conference to address benefits of CT scans
7. Breast cancer screening with MRI benefits women with radiation therapy history
8. Screening for cervical cancer low for immigrant women
9. Repeat MRI screening for breast cancer results in fewer false positives
10. Study finds MRSA screening saves hospitals money
11. More Screenings May Explain Higher Chlamydia Rates Among Minorities
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/2/2016)... Las Vegas, NV (PRWEB) , ... May 02, ... ... with Specialty Pharmacy Times, has announced a new Specialty Pharmacy Patient Satisfaction Award ... be determined based on the quarterly results from Zitter Health Insights’ Specialty Pharmacy ...
(Date:5/2/2016)... , ... May 02, 2016 ... ... report that many commonly used prescription medications, including anxiolytics, painkillers, antidepressants and ... these risks, Novus Medical Detox Center —a leading Florida-based drug treatment ...
(Date:5/2/2016)... ... May 02, 2016 , ... TeleMedCo™, a new company developing ... and improve the rapid diagnosis, triage and admission of patients leveraging IBM Watson’s ... mobile experience for the first time at GENBAND’s Perspectives16 conference. , TeleMedCo ...
(Date:5/2/2016)... ... May 02, 2016 , ... Atlantic Information Services, Inc. (AIS) is pleased to ... Could Transform the Pharma Landscape .” CMS recently proposed a test of alternate payment ... drugs while preserving care provided to beneficiaries. The webinar will review the details of ...
(Date:5/2/2016)... ... May 02, 2016 , ... The debilitating disease of arthritis ... With no cure, most patients must deal with prescription costs to treat arthritis over ... up to 75% savings at the pharmacy on many common prescriptions. , Arthritis , ...
Breaking Medicine News(10 mins):
(Date:5/2/2016)... , May 2, 2016  Deerfield announced ... financing of Graybug Vision, Inc. Graybug Vision is ... therapies that may transform care for ocular diseases ... Graybug Vision,s technology was first developed at Johns ... a startup venture. Graybug Vision ...
(Date:4/29/2016)... April 29, 2016  In the next ten ... shift from systems dependent on CRTs monitors to those ... modality CRT Medical monitors and will automatically sync ... host of foreseeable benefits to this technological advancement, ... modalities have to be replaced in order to ...
(Date:4/29/2016)... , April 29, 2016 ... glyco-biology expertise, today announces the appointment of Dr. ... Dr. Zurlo is an oncologist with many years clinical ... and biotechnology industries. His last role was at Mologen ... of the Executive Board. Previously Dr. Zurlo held various ...
Breaking Medicine Technology: