Abstract
Clinicians screen for prostate specific antigen (PSA) with the goal of identifying localized disease before it becomes systemic and kills the patient. Only a prostate biopsy can confirm the suspicion of prostate cancer raised by an elevated PSA. When first proposed as a screening test in 1991, the cut point was set at 4 ng/mL.1 Unfortunately, controversy surrounding this practice has raged for the past three decades. Urologists often proceed with a prostate biopsy when values cross 3 ng/mL out of fear of missing clinically significant disease.
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