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More on PSA testing to detect early prostatic cancer.

We recently reported on the use of the test for prostate-specific antigen (PSA) as an important adjunct to the rectal examination in screening for cancer of the prostate. Although some authorities have believed that it should be routinely used, others have been concerned that the PSA test can be elevated in the absence of cancer--giving a false positive.

Now a study reported in the April 22 Journal of the American Medical Association shows that the level of PSA may begin rising from seven to 25 years before cancer of the prostate becomes evident by other means. This rise is more rapid than that among men with only benign prostatic enlargement.

"Our study shows that if you look at how quickly the PSA level is going up, you can reduce the error rate for detecting cancer from 40 percent down to 10 percent," said Dr. Jay Pearson of the National Institute on Aging. Dr. Pearson is co-author of the study with a research team led by Dr. H. Ballentine Carter of the Johns Hopkins University School of Medicine.

The researchers hope their findings will greatly reduce the number of unnecessary biopsies done among men who might have cancer, based on rectal examination, but who are found to have only benign prostatic enlargement. (Almost all males endure benignly enlarged prostates as they grow older.)

Compared to the cost ($350-$500) and the inconvenience of biopsy, the PSA blood test (which costs about $35) is a reasonable addition to the annual rectal examination that all men over 50 should have.

American doctors can expect to diagnose 132,000 cases of prostate cancer this year. Although a single PSA test result may have little significance, having one done each year will show a trend that quickly appears if prostate cancer is beginning to develop--and often long before it is detected by rectal examination.
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Title Annotation:prostate-specific-antigen
Publication:Medical Update
Date:Jun 1, 1992
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