Tags: psa | prostate | cancer | death

PSA Changes Over Time Flag Cancer Risk

Thursday, 17 January 2013 10:30 AM

Changes in prostate specific antigen levels over time can offer significant clues to which patients are more likely to develop aggressive, life-threatening cancers, a new Kaiser Permanente study suggests.
Despite the recent controversy over of the use of PSA tests — the most commonly used screening method for prostate cancer today — the new findings indicate they may play an important role in helping to accurately identify men who are more likely to be at risk of death from more lethal, fast-growing tumors.
"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," said lead researcher Lauren P. Wallner, a post-doctoral research fellow at Kaiser Permanente Southern California's Department of Research & Evaluation.
“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. [But] 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."
For the study, published in the British Journal of Urology International, Wallner and colleagues examined the electronic health records of nearly 220,000 men (ages 45 and older) who had at least one PSA measurement and no history of prostate cancer over a 10-year period.
The results showed that annual percent changes in PSA more accurately predicted the presence of aggressive prostate cancer, compared to single measurements of PSA alone, but only slightly improved the prediction of prostate cancer overall. Men in the study were found to experience a 2.9 percent change in PSA levels per year on average and that the 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. "While we do not suggest that patients proactively seek out additional PSA measurements, men who already have had multiple PSAs may consider discussing the change in their PSA levels with their clinician when determining future treatment strategies."
The PSA test measures the level of an antigen, made by the prostate, in a man's blood. The higher the PSA level, the more likely a prostate problem is present. But many factors, such as age, race, and non-cancerous conditions can affect PSA levels.
The U.S. Preventive Services Task Force recommends against PSA screening for men who do not have symptoms. But many health experts recommend that men age 40 and older consult their doctors about the PSA test.
After non-melanoma skin cancer, prostate cancer is the most common cancer among American men. It is diagnosed in more than 215,000 men annually; 28,000 die from the disease each year.

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Changes in PSA levels over time can ID patients more likely to develop aggressive life-threatening cancers, a new study suggests.
Thursday, 17 January 2013 10:30 AM
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