BIOMARKER ASSAYS FOR ELEVATED PSA RISK ANALYSIS

Course overview

SERUM PROSTATE-SPECIFIC ANTIGEN (PSA) IS THE GOLD STANDARD LABORATORY INVESTIGATION FOR PROSTATE CANCER SCREENING AND EARLY DETECTION. AS A SCREENING BIOMARKER, PSA IS A SENSITIVE TOOL, BUT ITS SPECIFICITY IS LOW. IN ADDITION, MANY BENIGN CONDITIONS LIKE BPH, PROSTATITIS, AND MANIPULATIONS LIKE DRE, BIOPSY, AND URETHRAL CATHETERIZATION CAN INCREASE PSA LEVELS. CONSEQUENTLY, DIAGNOSIS WITH PSA ALONE CAN LEAD TO OVERDIAGNOSIS AND UNNECESSARY BIOPSIES ADDING PRESSURE ON HEALTHCARE SYSTEMS. THEREFORE, PROSTATIC RISK STRATIFICATION BIOMARKERS ARE INTENDED FOR USE PRIMARILY IN LOWER-RISK AND SELECTED BORDERLINE PATIENTS WITH MARGINALLY ELEVATED PSA LEVELS (TYPICALLY 4 NG/ML TO 10 NG/ML) WHERE AN ADVERSE FINDING WOULD LIKELY RESULT IN THE AVOIDANCE OF IMMEDIATE FURTHER TESTING, PROSTATIC IMAGING, BIOPSIES, OR OTHER DIAGNOSTIC PROCEDURES. THIS ARTICLE REVIEWS THE CURRENT STATUS OF THE AVAILABLE RISK-STRATIFICATION BIOMARKERS OR THOSE UNDERGOING INVESTIGATION.