Researchers at Memorial Sloan-Kettering Cancer Center have found that change in PSA levels over time — known as PSA velocity — is a poor predictor of prostate cancer and may lead to many unnecessary biopsies. The new study of more than 5,000 men was published online February 24 in the Journal of the National Cancer Institute. Andrew Vickers, PhD, Associate Attending Research Methodologist in the Department of Epidemiology and Biostatistics and lead author said, "We have found no evidence to support the recommendation that men with a high PSA velocity should be biopsied in the absence of other indications. In other words, if a man's PSA has risen rapidly in recent years, there is no cause for concern if his total PSA level is still low and his clinical exam is normal."
Prostate cancer is the most common cancer among American men and the second leading cause of cancer deaths in men, according to the American Cancer Society. While PSA screening is widely used for the early detection of prostate cancer, it is also associated with a high rate of overdiagnosis, which can lead to unnecessary treatment and anxiety. Currently, early detection guidelines of several organizations (the National Cancer Center Network and the American Urological Association) recommend that men with a rapid rise in PSA — or a high PSA velocity — have a surgical biopsy for prostate cancer, even if there are no other indicators that cancer may exist. Those indicators could be an elevated baseline PSA or a positive digital rectal exam (DRE).