Clinical Guideline: PSA - Reported From The Annual Meeting Of The American Urological Association

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology
Article Date: 19 Jun 2008 - 2:00 PDT

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ORLANDO, FL (UroToday.com) - Dr. Kirsten Greene presented the PSA guidelines. The 2008 guidelines are an update from 2000. They performed a comprehensive literature review, had panel members review the articles then review them again under panel peer review. The consensus opinion is presently under final review. She presented the preliminary report.

It is a long process, as there are no prospective, randomized, controlled trials showing a survival benefit to CaP screening. The screening controversy is ongoing, but the NCCN, the AUA and the ACS support screening. Completion of screening trials in Europe and the US will facilitate the appropriate conclusions.

In 2000, age 50 was used to start screening, but age 40 is now being considered. The biopsy threshold was 4.0ng/ml, but a continuum of risk with a range of PSA is being considered. PSAV may be a better indicator of risk compared to an absolute value. African-American men should have screening earlier and PSA is more sensitive in younger men. Prostate volume, complexed PSA, free/total PSA, PSAD and PSA isoforms are under consideration. Risk stratification tables may facilitate a patient's decision regarding screening and biopsy. All these factors rather than a threshold value will be considered in the upcoming guidelines.

Presented by Kirsten L. Greene, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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