TY - JOUR
T1 - Evidence suggesting PSA cutpoint of 2.5 ng/mL for prompting prostate biopsy
T2 - Review of 36,316 biopsies
AU - Gilbert, Scott M.
AU - Cavallo, Christina B.
AU - Kahane, Hillel
AU - Lowe, Franklin C.
PY - 2005/3
Y1 - 2005/3
N2 - Objectives. To determine whether a prostate-specific antigen (PSA) level of 2.0, 2.5, or 4.0 ng/mL is the most appropriate cutpoint for determining the need for prostate biopsy. It has been suggested that the PSA cutpoint of 4.0 ng/mL is inappropriate because the rate of prostate cancer detection is similar in patients with lower PSA values. Some investigators have recommended a 2.6-ng/mL cutpoint. Others have recommended a cutpoint of 2.0 ng/mL. Methods. A total of 36,316 prostate biopsies submitted to DIANON Systems from January 1, 1997 through December 31, 2001 were reviewed. These biopsy specimens also had DIANON PSA test results available that had been performed within 6 months of the biopsy date. These biopsies were stratified according to the PSA level within the 6 months before the time of biopsy, and the prostate cancer detection rate was determined for the stratified PSA levels. Results. The detection rate of prostate cancer varied according to the PSA level. The incidence of prostate cancer was similar for the groups with less than 2.0 ng/mL and 2.0 to 2.5 ng/mL (18.67% and 21.89%, respectively). Also, the groups with 2.5 to 4.0 ng/mL and 4.0 to 10.0 ng/mL had similar cancer detection rates (27.48% and 30.08%, respectively). Conclusions. The prostate cancer detection rate for a PSA level between 2.5 and 4.0 ng/mL was similar (27.48%) to that for the PSA range of 4.0 to 10.0 ng/mL (30.08%). The absolute cutpoint used to determine the need to evaluate a patient for prostate cancer by biopsy is not clear; however, many studies have suggested that 2.5 ng/mL may be a more appropriate cutpoint than 4.0 ng/mL.
AB - Objectives. To determine whether a prostate-specific antigen (PSA) level of 2.0, 2.5, or 4.0 ng/mL is the most appropriate cutpoint for determining the need for prostate biopsy. It has been suggested that the PSA cutpoint of 4.0 ng/mL is inappropriate because the rate of prostate cancer detection is similar in patients with lower PSA values. Some investigators have recommended a 2.6-ng/mL cutpoint. Others have recommended a cutpoint of 2.0 ng/mL. Methods. A total of 36,316 prostate biopsies submitted to DIANON Systems from January 1, 1997 through December 31, 2001 were reviewed. These biopsy specimens also had DIANON PSA test results available that had been performed within 6 months of the biopsy date. These biopsies were stratified according to the PSA level within the 6 months before the time of biopsy, and the prostate cancer detection rate was determined for the stratified PSA levels. Results. The detection rate of prostate cancer varied according to the PSA level. The incidence of prostate cancer was similar for the groups with less than 2.0 ng/mL and 2.0 to 2.5 ng/mL (18.67% and 21.89%, respectively). Also, the groups with 2.5 to 4.0 ng/mL and 4.0 to 10.0 ng/mL had similar cancer detection rates (27.48% and 30.08%, respectively). Conclusions. The prostate cancer detection rate for a PSA level between 2.5 and 4.0 ng/mL was similar (27.48%) to that for the PSA range of 4.0 to 10.0 ng/mL (30.08%). The absolute cutpoint used to determine the need to evaluate a patient for prostate cancer by biopsy is not clear; however, many studies have suggested that 2.5 ng/mL may be a more appropriate cutpoint than 4.0 ng/mL.
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U2 - 10.1016/j.urology.2004.10.064
DO - 10.1016/j.urology.2004.10.064
M3 - Article
C2 - 15780374
AN - SCOPUS:15244361044
SN - 0090-4295
VL - 65
SP - 549
EP - 553
JO - Urology
JF - Urology
IS - 3
ER -
