The effect of percentage free prostate-specific antigen (PSA) level on the prostate cancer detection rate in a screening population with low PSA levels
Article first published online: 13 OCT 2005
Volume 96, Issue 7, pages 995–998, November 2005
How to Cite
Pelzer, A. E., Volgger, H., Bektic, J., Berger, A. P., Rehder, P., Bartsch, G. and Horninger, W. (2005), The effect of percentage free prostate-specific antigen (PSA) level on the prostate cancer detection rate in a screening population with low PSA levels. BJU International, 96: 995–998. doi: 10.1111/j.1464-410X.2005.05800.x
- Issue published online: 13 OCT 2005
- Article first published online: 13 OCT 2005
- Accepted for publication 5 July 2005
- prostate cancer;
- percentage free PSA;
- cancer detection rate;
To evaluate the prostate cancer detection rate at low total prostate-specific antigen (tPSA) ranges of 2.6–4 and 4.1–10 ng/mL, according to different percentage free (f/t) PSA levels in a screening population.
SUBJECTS AND METHODS
In all, 1809 consecutive screening volunteers with a tPSA level of 2.6–10.0 ng/mL were assessed. Ten systematic ultrasonography-guided prostate biopsies and, since 2000, an additional five Doppler-enhanced targeted biopsies were taken on the basis of age-specific tPSA reference ranges. We analysed the detection rate of prostate cancer according to f/tPSA ranges of 0–9%, 10–14%, 15–18% and >18%.
The detection rates for the subgroups with tPSA levels of 2.6–4.0 and 4.1–10.0 ng/mL were 20.2% and 27.0%, respectively. The cancer detection rate in the first group (2.6–4.0 ng/mL) at 0–10% fPSA was 22.9%, and that in the second group (4.1–10.0 ng/mL) at 0–10% was 36.9%. There were significant differences between these groups. If the f/tPSA was 10–15%, the cancer detection rate for the two groups were 22.6% and 32.5%, respectively (P < 0.05). There was no statistically significant difference in the cancer detecting rates at an f/tPSA of 15–18% or >18%.
There is a statistically significantly higher cancer detection rate when the f/tPSA is <15% than in groups of men with a f/tPSA of >15% in screening population assessed primarily using tPSA level.