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Prostate Biopsy pp 15–27Cite as

Prostate-Specific Antigen and Prostate Cancer Screening

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Part of the book series: Current Clinical Urology ((CCU))

Abstract

Although the Food and Drug Administration recommends a prostate-specific antigen (PSA) threshold of 4 ng/dL as abnormal, investigations into the use of lower thresholds have shown substantial positive predictive value. The authors recommend that screening for prostate cancer begin at age 40 years. Initial PSA value should be assessed in respect to the median PSA level for the patient’s age group. If findings on digital rectal examination are suspicious for prostate cancer or the total PSA is greater than 2.5 ng/dL, a 12-core transrectal ultrasonography—guided biopsy should be strongly considered. Both patient and physician should maintain a PSA flow chart that records all PSA values, the date of measurement, and the PSA assay used. Patients with persistent elevated PSA levels may benefit from further evaluation using other PSA parameters to improve prostate cancer detection and assessment of aggressiveness before biopsy. Parameters described in this chapter include percent free PSA, age-specific PSA levels, complexed PSA levels, PSA density, PSA transition zone density, PSA velocity, PSA doubling time, pro-PSA, and human glandular kallikrein.

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Author information

Authors and Affiliations

  1. Department of Urology, Georgetown University, Washington, DC

    Stacy Loeb MD

  2. Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL

    Misop Han MD & William J. Catalona MD

Authors
  1. Stacy Loeb MD
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  2. Misop Han MD
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  3. William J. Catalona MD
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Editor information

Editors and Affiliations

  1. Department of Regional Urology, Cleveland Clinic Glickman Urological and Kidney Institute, USA

    J. Stephen Jones MD (Chairman, Associate Professor of Surgery (Urology) (Chairman, Associate Professor of Surgery (Urology)

  2. Cleveland Clinic Lerner College of Medicine at CWRU, Cleveland, OH, USA

    J. Stephen Jones MD (Chairman, Associate Professor of Surgery (Urology) (Chairman, Associate Professor of Surgery (Urology)

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© 2008 Humana Press, a part of Springer Science+Business Media, LLC

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Loeb, S., Han, M., Catalona, W.J. (2008). Prostate-Specific Antigen and Prostate Cancer Screening. In: Jones, J.S. (eds) Prostate Biopsy. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-60327-078-6_3

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  • DOI: https://doi.org/10.1007/978-1-60327-078-6_3

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-790-7

  • Online ISBN: 978-1-60327-078-6

  • eBook Packages: MedicineMedicine (R0)

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