A new study shows PSA velocity (PSAV) risk count testing in which a man’s PSA levels are tracked over time may help doctors more accurately assess for clinically significant prostate cancer. The new study by NYU Langone Medical Center and Northwestern University Feinberg School of Medicine was published online by the British Journal of Urology International on February 1, 2012.
Lead author Stacy Loeb, MD, says, “Risk count could represent a new way to screen for prostate cancer by focusing on men with the greatest risk of harmful prostate cancers.” Loeb is an urologist in the department of urology and the Joel E. Smilow Comprehensive Prostate Cancer Center at NYU Langone. “The goal of risk count is to help identify the aggressive, clinically significant prostate cancers before advanced symptoms develop, while decreasing the diagnosis of insignificant cancers.”
Because prostate cancer does not present symptoms until advanced stages, screening for the disease is crucial.
Instead of relying on just 1 PSA test result to determine prostate cancer risk, the new PSAV risk count screening examines fluctuations in PSA levels over time to establish a man’s prostate cancer risk. PSAV calculations for risk involve counting the number of times in a row in which the blood PSA level increases by 0.4 ng/mL. If PSA rises by more than 0.4 units multiple years in a row, the risk count increases, thus indicating a greater risk of aggressive prostate cancer.
In the study, researchers evaluated 18,214 men who underwent prostate cancer screening, 1125 of whom were diagnosed with the disease. The study results show PSAV risk count could improve the specificity of screening for prostate cancer and more advanced stages of the disease. More specifically, sustained rises in PSA levels over time indicate a significantly greater risk of prostate cancer and more aggressive disease.
Loeb and colleagues suggest risk count screening may be useful in:
“A persistently rising PSA is a harbinger for life-threatening prostate cancer,” said the study’s senior author, William Catalona, MD, professor of Urology at Northwestern University. “Our study findings show looking at how much PSA changes over time helps distinguish which cancers are aggressive more so than a single PSA value.”
Source: NYU Langone Medical Center.
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