PSA tests have been lauded as important diagnostic tools for prostate cancer, however much of the data used to make this conclusion were generated in the early to mid 1990s, when prostate biopsies were performed differently than they are today. Since that time, there has been an increase in the number of prostate biopsies performed and an increasing number of biopsy samples taken from each patient.
Douglas Scherr, MD, Michael Schwartz, MD, and colleagues at the New York Presbyterian Hospital of the Weill Medical College of Cornell University, in New York City, set out to assess whether changes in prostate biopsy practices might have changed the predictive value of PSA tests.
The researchers performed a retrospective analysis of all prostate biopsies performed at their institution between 1993 and 2005, finding 1,607 that satisfied their inclusion and exclusion criteria. Douglas Scherr, MD and his team divided patients into three groups based on when they received their biopsies: 1993-1997, 1998-2001, and 2002-2005. They examined each group for the number of biopsies performed, the number of positive biopsies, patient age, most recent PSA prior to biopsy, prostate volume, and number of biopsy samples taken. With these data in hand, they assessed potential correlations between PSA levels and positive biopsy rate.
The investigators found that the number of biopsies performed, the percentage of positive biopsies, and patient ages did not change significantly over time. However, there was a significant decrease in the median PSA level in patients undergoing biopsy and an increase in the median number of samples taken at the time of biopsy. Also, fewer biopsies were performed for the indication of a suspicious digital rectal exam and there was an increase in the percentage of patients undergoing biopsy for PSA readings between 2.5 and 3.99 ng/ml. (According to the American Cancer Society, the PSA level usually goes above 4 ng/ml when prostate cancer develops, but about 15% of men with a PSA below 4 ng/ml will have prostate cancer on biopsy.)
The positive biopsy rate in men with PSA levels in the 2.0 to 3.99 ng/ml range equaled or surpassed that for patients with higher PSA readings. Therefore, the researchers concluded that ¡°the correlation between PSA and positive biopsy rate no longer holds true in our patient population for men with a normal digital rectal exam and PSA ¡Ý2.0 ng/ml.¡±
While changes in biopsy practice patterns have improved cancer detection, these very changes ¡°have negatively influenced the predictive value of PSA in men with a normal digital rectal exam such that, using current biopsy practice patterns, PSA no longer correlates with positive biopsy rate,¡± note the authors. They cite the urgent need for new blood or urinary markers to better determine who needs a prostate biopsy, adding that aside from family history or prior atypical biopsy findings, there is little other information available to help physicians decide who needs a biopsy and who does not.
Amy Molnar | EurekAlert!
Statistical method developed at TU Dresden allows the detection of higher order dependencies
07.02.2020 | Technische Universität Dresden
Novel study underscores microbial individuality
13.12.2019 | Bigelow Laboratory for Ocean Sciences
Together with their colleagues from the University of Würzburg, physicists from the group of Professor Alexander Szameit at the University of Rostock have devised a “funnel” for photons. Their discovery was recently published in the renowned journal Science and holds great promise for novel ultra-sensitive detectors as well as innovative applications in telecommunications and information processing.
The quantum-optical properties of light and its interaction with matter has fascinated the Rostock professor Alexander Szameit since College.
Researchers at the University of Zurich show that different stem cell populations are innervated in distinct ways. Innervation may therefore be crucial for proper tissue regeneration. They also demonstrate that cancer stem cells likewise establish contacts with nerves. Targeting tumour innervation could thus lead to new cancer therapies.
Stem cells can generate a variety of specific tissues and are increasingly used for clinical applications such as the replacement of bone or cartilage....
An international research team led by Kiel University develops an extremely porous material made of "white graphene" for new laser light applications
With a porosity of 99.99 %, it consists practically only of air, making it one of the lightest materials in the world: Aerobornitride is the name of the...
Researchers at Graz University of Technology have developed a framework by which wireless devices with different radio technologies will be able to communicate directly with each other.
Whether networked vehicles that warn of traffic jams in real time, household appliances that can be operated remotely, "wearables" that monitor physical...
Terahertz waves are becoming ever more important in science and technology. They enable us to unravel the properties of future materials, test the quality of...
26.03.2020 | Event News
23.03.2020 | Event News
03.03.2020 | Event News
27.03.2020 | Power and Electrical Engineering
27.03.2020 | Life Sciences
27.03.2020 | Life Sciences