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Rapid Rise in PSA Levels a Poor Predictor of Prostate Cancer: Study
Date:2/24/2011

By Jenifer Goodwin
HealthDay Reporter

THURSDAY, Feb. 24 (HealthDay News) -- Blood tests that indicate prostate-specific antigen (PSA) levels are rising rapidly over time are of little use in detecting aggressive prostate cancer and should not be done, a new study indicates.

PSA is a protein produced by cells of the prostate gland. High levels of PSA can be a marker for prostate cancer, although it's far from a perfect screening tool, experts say. Men with both high and low levels of PSA can have cancer or not have cancer.

The thought was that since high PSA levels are correlated with prostate cancer, rapidly rising levels of PSA, called "PSA velocity," from one year to another would also be an indicator of prostate cancer.

However, the new study found that PSA velocity doesn't add any useful information beyond what physicians can already tell from other methods of prostate cancer screening, including the one-time PSA level test and digital rectal exams.

Current screening guidelines that recommend biopsies for men who have high PSA velocity but no other signs of prostate cancer -- such as a suspected abnormality during a digital rectal exam or high PSA level during a single test -- are leading to many unnecessary biopsies, the researchers said.

"We found there was no strong association between PSA velocity and prostate cancer, and virtually none with aggressive prostate cancer," said study author Andrew Vickers, of Memorial Sloan-Kettering Cancer Center in New York City. "The velocity didn't add anything more to detecting aggressive prostate cancers."

The study is published online Feb. 24 in the Journal of the National Cancer Institute.

The whole issue of prostate cancer screening -- including the PSA test, the digital rectal exam and PSA velocity -- has been controversial, said Dr. Otis Brawley, chief medical officer of the American Cancer Society (ACS).

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