Is Prostate Specific Antigen Velocity Selective For Clinically Significant Prostate Cancer In Screening?

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Men's health;  Clinical Trials / Drug Trials
Article Date: 03 May 2008 - 0:00 PDT

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UroToday.com - With the knowledge that screening for prostate cancer will lead to over detection and subsequent over treatment, the call for tests discriminating between non aggressive and aggressive prostate cancer is growing. If pre-biopsy data could make this distinction, a lot of unnecessary biopsies would be spared.

The amount of prostate cancer specific antigen (PSA) increase in a year, PSA velocity (PSAV), has been suggested as a factor predictive for aggressive disease. Therefore, PSAV was calculated in a large, population-based screening cohort (n=2217) and its predictive value on aggressive prostate cancer was assessed. It is important to note that each screening subject was biopsied at the time of the last PSA determination. Therefore, the presence or absence for each individual was known and the attribution bias was brought to a minimum.

Although PSAV was predictive of aggressive disease when assessed as a single variable, this predictive value was lost when more clinical data were added in the analysis. These data consisted of age, PSA, prostate volume, digital rectal examination, transrectal ultrasound examination and having had a previous negative biopsy. Thus, PSAV did not contribute significantly to predicting aggressive disease compared to already routinely used parameters.

PSAV has been shown to be predictive of unfavorable patient outcome in patients who are already diagnosed with prostate cancer. The value of PSAV as a pre-biopsy factor however is not yet established.

Written by Tineke Wolters, Monique J. Roobol, Chris H. Bangma and Fritz H. Schröder as part of Beyond the Abstract on UroToday.com

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