THE AUTHORS OF A NEW STUDY ARgue that an add-on to improve traditional prostate-specific antigen (PSA) screening for prostate cancer provides minimal benefit in identifying those cancers that are truly life threatening and should not be recommended in practice guidelines. But other experts reject this controversial opinion. PSA screening remains a less-thanideal method for detecting deadly prostate cancer, and researchers have tried to improve its specificity by adding other variables, such as race or family history, or different measures of PSA level, such as free PSA and PSA isoforms. One measure that has gained some acceptance in the clinical setting is PSA velocity, or the rate of change of PSA level. Current guidelines recommend that for men with a high PSA velocity (greater than 0.35 or 0.40 ng/mL per year), biopsy should be considered even if absolute PSA levels are very low. Traditionally, biopsy is suggested as a reasonable test for those men whose PSA levels are 4.0 ng/mL or higher. Andrew J. Vickers, PhD, an associate attendingresearchmethodologist atMemorialSloan-KetteringCancerCenter in NewYorkCityandleadauthorofthenew study, said the findings suggest that PSA velocitydoesnotaddbenefittotraditional PSAscreeningandcan lead to1 in7men whomeetguidelinecriteriaforbiopsydue to high PSA velocity having an unnecessaryprostatebiopsy(VickersAJetal.JNatl Cancer Inst. 2011;103[6]:462-469). “We did not find any good evidence that PSA velocity helped; it did not tell you any more than PSA alone,” Vickers said. “The problem is that PSA and PSA velocity are highly correlated.” Vickers’ study looked at 5519 men enrolled in the Prostate Cancer Prevention Trial who were aged 55 years or older, with no previous prostate cancer diagnosis, normal digital rectal examination