How often is cancer detected when serum PSA is elevated? What factors affect the prostate cancer detection rate?


The detection rate of prostate cancer is influenced by several factors: clinical features including the serum PSA level and an abnormal digital rectal examination (DRE); the number of biopsy cores examined; and the volume of the prostate. Among men with serum PSA < 4ng/ml, 4–10ng/ml, and >10ng/ml, cancer detection rates by prostate needle core biopsy (PNB) are approximately 15%, 25%, and 60%, respectively. Men with low screening PSA (<4 ng/ml) and treated with radical prostatectomy have smaller cancers, lower Gleason scores, lower pathologic tumor stages, and lower PSA recurrence rates than men with higher PSA levels (≥4 ng/ml). If the initial serum PSA values are >10ng/ml, cancers are pathologically in more advanced stages. Cancers detected with an abnormal DRE are more frequently in advanced stages than those discovered by PSA screening.


Prostate Cancer Cancer Detection Rate Radical Prostatectomy Specimen Sextant Biopsy Abnormal Digital Rectal Examination 


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