Abstract
Although the serum prostate-specific antigen (PSA) level has been accepted as 1 of the 3 tools for prostatic cancer screening (along with the digital rectal examination and transrectal ultrasonography), the actual value of the early detection of prostate cancer in the elderly is still a subject of debate. The diagnosis of preclinical disease with the probable lower propensity for clinical progression could have resulted in the performance of a more radical prostatectomies than absolutely necessary within the screened population. The present study does make a case for lowering the threshold for “significant PSA levels” to warrant a prostate biopsy. We would like to share our own concerns regarding the conflicting data in published reports on the true significance of PSA levels in the screening process. Detection Rates of Nonpalpable Prostate Cancer in Korean Men With Prostate-specific Antigen Levels Between 2.5 and 4.0 ng/mLUrologyVol. 76Issue 4PreviewTo evaluate the detection rate and pathology of cancer in Korean men with low levels of prostate-specific antigen (PSA), 2.5-4.0 ng/mL. Full-Text PDF Reply by the AuthorsUrologyVol. 77Issue 4PreviewWe appreciate the informative comments about our report. In Korea, a prostate-specific antigen (PSA) level of ≥4 ng/mL is considered an indication for prostate biopsy. However, many investigators have reported a high prevalence of prostate cancer at lower PSA cutoffs. Most of these cancers were found to have pathologic features consistent with clinically significant disease. Catalona et al1 reported that prostate cancer was detected in 73 (22%) of 332 men who had undergone biopsy with a PSA level of 2.6-4.0 ng/mL and normal prostate examination findings. Full-Text PDF
Published Version
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