Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Biopsy techniques have made PSA test less predictive

11.03.2008
Prostate specific antigen (PSA) levels typically have correlated with prostate biopsy results in the detection of prostate cancer, but that correlation no longer exists for men with a normal prostate exam, according to a new study published in the April 15, 2008 issue of CANCER, a peer-reviewed journal of the American Cancer Society. The study suggests that improved biopsy techniques make PSA less useful in prostate cancer screening.

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!
Further information:
http://www.wiley.com

More articles from Studies and Analyses:

nachricht Deep Brain Stimulation Provides Sustained Relief for Severe Depression
19.03.2019 | Universitätsklinikum Freiburg

nachricht AI study of risk factors in type 1 diabetes
06.03.2019 | University of Gothenburg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: The taming of the light screw

DESY and MPSD scientists create high-order harmonics from solids with controlled polarization states, taking advantage of both crystal symmetry and attosecond electronic dynamics. The newly demonstrated technique might find intriguing applications in petahertz electronics and for spectroscopic studies of novel quantum materials.

The nonlinear process of high-order harmonic generation (HHG) in gases is one of the cornerstones of attosecond science (an attosecond is a billionth of a...

Im Focus: Magnetic micro-boats

Nano- and microtechnology are promising candidates not only for medical applications such as drug delivery but also for the creation of little robots or flexible integrated sensors. Scientists from the Max Planck Institute for Polymer Research (MPI-P) have created magnetic microparticles, with a newly developed method, that could pave the way for building micro-motors or guiding drugs in the human body to a target, like a tumor. The preparation of such structures as well as their remote-control can be regulated using magnetic fields and therefore can find application in an array of domains.

The magnetic properties of a material control how this material responds to the presence of a magnetic field. Iron oxide is the main component of rust but also...

Im Focus: Self-healing coating made of corn starch makes small scratches disappear through heat

Due to the special arrangement of its molecules, a new coating made of corn starch is able to repair small scratches by itself through heat: The cross-linking via ring-shaped molecules makes the material mobile, so that it compensates for the scratches and these disappear again.

Superficial micro-scratches on the car body or on other high-gloss surfaces are harmless, but annoying. Especially in the luxury segment such surfaces are...

Im Focus: Stellar cartography

The Potsdam Echelle Polarimetric and Spectroscopic Instrument (PEPSI) at the Large Binocular Telescope (LBT) in Arizona released its first image of the surface magnetic field of another star. In a paper in the European journal Astronomy & Astrophysics, the PEPSI team presents a Zeeman- Doppler-Image of the surface of the magnetically active star II Pegasi.

A special technique allows astronomers to resolve the surfaces of faraway stars. Those are otherwise only seen as point sources, even in the largest telescopes...

Im Focus: Heading towards a tsunami of light

Researchers at Chalmers University of Technology and the University of Gothenburg, Sweden, have proposed a way to create a completely new source of radiation. Ultra-intense light pulses consist of the motion of a single wave and can be described as a tsunami of light. The strong wave can be used to study interactions between matter and light in a unique way. Their research is now published in the scientific journal Physical Review Letters.

"This source of radiation lets us look at reality through a new angle - it is like twisting a mirror and discovering something completely different," says...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

International Modelica Conference with 330 visitors from 21 countries at OTH Regensburg

11.03.2019 | Event News

Selection Completed: 580 Young Scientists from 88 Countries at the Lindau Nobel Laureate Meeting

01.03.2019 | Event News

LightMAT 2019 – 3rd International Conference on Light Materials – Science and Technology

28.02.2019 | Event News

 
Latest News

Solving the efficiency of Gram-negative bacteria

22.03.2019 | Life Sciences

Bacteria bide their time when antibiotics attack

22.03.2019 | Life Sciences

Open source software helps researchers extract key insights from huge sensor datasets

22.03.2019 | Information Technology

VideoLinks
Science & Research
Overview of more VideoLinks >>>