Screening Younger Men for Prostate Cancer?

Ivanhoe Newswire
Thursday, November 2, 2006; 12:00 AM

(Ivanhoe Newswire) -- When it comes to PSA levels, it's not a matter of how high, but how fast, report Johns Hopkins researchers in a new study.

Their results link quickly rising PSA levels with a significantly greater risk of developing a dangerous form of cancer that can lead to death. Men with higher levels to begin with who maintain those levels over time are actually at lower risk for this type of cancer than men with lower initial levels that accelerate at a faster rate.

PSA, or prostate-specific antigen, is a protein produced by both healthy and cancerous prostate cells. A higher level is a possible indicator of cancer.

The findings could change the way doctors test for and respond to PSA levels. Right now, men must have a certain level of PSA in the blood to trigger the need for a biopsy to test for prostate cancer. If the new findings bear out, doctors may look more closely at PSA velocity instead, performing biopsies on men who previously would not have been candidates for such tests.

The key, note the researchers, is to begin PSA testing earlier in life -- at about age 40 rather than at age 50 -- to determine a man's normal level before age-related changes begin. Then doctors can accurately measure how fast PSA increases over time, hopefully catching potentially deadly cancers early enough so they can be effectively treated.

"Our data provide a further argument for PSA testing that begins relatively early in life, when PSA levels are usually lower and prostate enlargement is absent, to establish a baseline for evaluating future changes in PSA levels," the authors write.

The study was based on frozen blood samples taken from nearly 1,000 men as far back as the 1950s.

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SOURCE: Journal of the National Cancer Institute, 2006;98:1509-1510