Relationship between PSA score and prostate cancer has steadily declined

Results of a new study unveiled today indicate that the relationship between PSA score and prostate cancer has steadily declined during the last 20 years, an important finding given that PSA score is often used to determine whether biopsy for prostate cancer testing is necessary. Two decades ago, serum PSA was highly related to prostate cancer, but in the last five years, according to the study, PSA is only related to benign prostatic hyperplasia (BPH).

The study examined 1,317 consecutive untreated radical prostatectomies at Stanford since August of 1983 for the relationship of serum PSA to the largest cancer in four, five-year intervals. Prostates were examined sequentially in 3 mm step-sections by one pathologist, measuring the volume of the largest cancer, the percent Gleason grade 4/5, and less important histologic parameters.

“The AUA feels that PSA – in combination with digital rectal exam and a full review of the patient’s history – is the best way to indicate when a prostate biopsy might be necessary,” said AUA President Martin I. Resnick, M.D. “However, we recognize that the test is not foolproof, and that we need more research to improve its specificity and sensitivity.”

The study was released at the AUA’s 99th Annual Scientific Meeting, held in the San Francisco Moscone Center.

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