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The effect of percentage free prostate‐specific antigen (PSA) level on the prostate cancer detection rate in a screening population with low PSA levels
Author(s) -
Pelzer Alexandre E.,
Volgger Hubert,
Bektic Jasmin,
Berger Andreas P.,
Rehder Peter,
Bartsch Georg,
Horninger Wolfgang
Publication year - 2005
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2005.05800.x
Subject(s) - prostate cancer , medicine , urology , prostate specific antigen , cancer detection , prostate , population , cancer , transrectal ultrasonography , significant difference , gynecology , environmental health
OBJECTIVE To evaluate the prostate cancer detection rate at low total prostate‐specific antigen (tPSA) ranges of 2.6–4 and 4.1–10 ng/mL, according to different percentage free (f/t) PSA levels in a screening population. SUBJECTS AND METHODS In all, 1809 consecutive screening volunteers with a tPSA level of 2.6–10.0 ng/mL were assessed. Ten systematic ultrasonography‐guided prostate biopsies and, since 2000, an additional five Doppler‐enhanced targeted biopsies were taken on the basis of age‐specific tPSA reference ranges. We analysed the detection rate of prostate cancer according to f/tPSA ranges of 0–9%, 10–14%, 15–18% and >18%. RESULTS The detection rates for the subgroups with tPSA levels of 2.6–4.0 and 4.1–10.0 ng/mL were 20.2% and 27.0%, respectively. The cancer detection rate in the first group (2.6–4.0 ng/mL) at 0–10% fPSA was 22.9%, and that in the second group (4.1–10.0 ng/mL) at 0–10% was 36.9%. There were significant differences between these groups. If the f/tPSA was 10–15%, the cancer detection rate for the two groups were 22.6% and 32.5%, respectively ( P < 0.05). There was no statistically significant difference in the cancer detecting rates at an f/tPSA of 15–18% or >18%. CONCLUSION There is a statistically significantly higher cancer detection rate when the f/tPSA is <15% than in groups of men with a f/tPSA of >15% in screening population assessed primarily using tPSA level.