Speed of PSA change 'does not predict risk of cancer'

Changes to PSA levels over time are no more accurate at predicting prostate cancer than actual PSA, a large European study has shown.

Prostate cancer: diagnosis via PSA velocity 'no better than PSA/age'
Prostate cancer: diagnosis via PSA velocity 'no better than PSA/age'

The finding conflicts with previous studies, and new US data, suggesting that the rate at which PSA increases over time (PSA velocity) could be a better predictor of prostate cancer than single PSA measurements.

Researchers calculated the PSA velocity of 2,742 men who took part in a prostate cancer screening programme and subsequently underwent biopsy because of raised PSA levels.

Although PSA velocity was statistically associated with prostate cancer, it did not improve on the predictive accuracy of using PSA and age alone.

The researchers conclude that there is little justification for calculating PSA velocity when determining whether to refer for biopsy or not.

Meanwhile, a US study presented at a meeting of the American Urological Association supports the opposite view.

It included 616 men aged 40 to 79 who underwent PSA measurement every two years for 17 years. PSA levels of men who subsequently developed prostate cancer increased yearly by an average of 6 per cent, compared with 3.3 per cent in those not diagnosed with cancer.

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