Changes in PSA more accurately predict presence of aggressive prostate cancer
When compared with a single measurement of prostate specific antigen (PSA), measurements taken over time improve accuracy when detecting aggressive prostate cancer, according to a Kaiser Permanente study.
“Our study demonstrates that repeated measurements of PSA over time could provide a more accurate – and much needed – detection strategy for aggressive forms of prostate cancer,” said Lauren P. Wallner, PhD, MPH, study lead author and postdoctoral research fellow at Kaiser Permanente Southern California’s Department of Research & Evaluation.
For the retrospective study, published recently in the British Journal of Urology International, Wallner and colleagues studied the electronic health records of almost 220,000 men over a 10-year period. The patients were 45 years or older and had at least 1 PSA measurement and no previous diagnosis of prostate cancer. The study found that, when compared with single measurements of PSA alone, annual percent changes in PSA more accurately predicted the presence of aggressive prostate cancer but only slightly improved the prediction of prostate cancer overall.
“The use of a single, elevated PSA level to screen for prostate cancer is considered controversial given the questionable benefits of PSA screening on prostate cancer mortality. The screening may also result in unnecessary prostate biopsies and subsequent treatments for localized prostate cancer, as it does not distinguish well between slow-growing and aggressive disease,” said Wallner.
Researchers also discovered that the men in the study experienced a 2.9% change in PSA levels per year on average. This rate of change in PSA increased modestly with age.
“The results of this study could provide clinicians with a better prostate cancer preventive strategy that could help differentiate between men with an aggressive form of the disease and those who have slow-growing, indolent cancer that may not necessarily merit treatment,” said Wallner.
Source: Kaiser Permanente.