Abstract
Simple SummaryProstate cancer (PCa) represents a very important health problem worldwide. Used as the main screening method for almost four decades, PSA (Prostate Specific Antigen) has proven its limitations. In this review, the authors try to make an evaluation of the biomarkers commercially available and used to improve the PCa detection in patients with elevated PSA. The authors also present the current PCa screening and diagnosis protocols in Romania.The prostate is one of the most clinically accessible internal organs of the genitourinary tract in men. For decades, the only method of screening for prostate cancer (PCa) has been digital rectal examination of 1990s significantly increased the incidence and prevalence of PCa and consequently the morbidity and mortality associated with this disease. In addition, the different types of oncology treatment methods have been linked to specific complications and side effects, which would affect the patient’s quality of life. In the first two decades of the 21st century, over-detection and over-treatment of PCa patients has generated enormous costs for health systems, especially in Europe and the United States. The Prostate Specific Antigen (PSA) is still the most common and accessible screening blood test for PCa, but with low sensibility and specificity at lower values (<10 ng/mL). Therefore, in order to avoid unnecessary biopsies, several screening tests (blood, urine, or genetic) have been developed. This review analyzes the most used bioumoral markers for PCa screening and also those that could predict the evolution of metastases of patients diagnosed with PCa.
Highlights
Prostate cancer (PCa) was in 2020 the second most common cancer and the fifth leading cause of death among the male population worldwide, accounting for 6.8% of all male cancer mortality [1]
According to the National Academy of Clinical Biochemistry (NACB), the use of %free Prostate Specific Antigen (PSA) (fPSA) is recommended to differentiate patients with a suspicion of prostate cancer from those with benign prostatic hyperplasia (BPH), when total serum PSA levels are between 4–10 ng/mL [33]
Prostate Health Index (PHI) is not recommended to be used in the initial screening for PCa, but it may be considered in the years as an efficient evaluation method for patients with PSA values between 2 ng/mL and 10 ng/mL [74]
Summary
Prostate cancer (PCa) was in 2020 the second most common cancer and the fifth leading cause of death among the male population worldwide, accounting for 6.8% of all male cancer mortality [1]. The FDA first approved Prostate-specific antigen screening in 1986 as a prognostic marker for PCa. The introduction of PSA in PCa screening and diagnosis represented a revolution in the disease management, with a significant increase of PCa’s incidence and prevalence due to patients’ diagnosis in earlier stages, resulting in a reduction in mortality rates [22]. A prospective multicenter study, based on 831 patients showed that using a cutoff point of 2.5 ng/mL for total PSA and 2.2 ng/mL for Complexed PSA, with the cPSA range between 1.5 to 3.2 ng/mL provided a specificity of 21.2% and 35%, respectively, and a sensitivity of 85% for prostate cancer detection [36]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
