Published 24 September 2009, doi:10.1136/bmj.b3572
Cite this as: BMJ 2009;339:b3572

Editorials

Prostate specific antigen for detecting early prostate cancer

Evidence is inconclusive, so patient education and shared decision making are essential

The first 150 words of the full text of this article appear below.

Clinicians currently rely on prostate specific antigen (PSA) measurement and digital rectal examination as frontline tests for screening and diagnosing prostate cancer. Much of the controversy surrounding the merits of the PSA test is based on uncertainty about its performance in population screening. In the linked study (doi:10.1136/bmj.b3537), Holmström and colleagues show the test’s limitations in this context.3

In the early 1990s, the PSA test was at the forefront of prostate cancer screening and a threshold of 4 µg/l was set. This value was thought to allow detection of many curable cancers, while limiting the number of false positives and the need for men to undergo further invasive tests.1 Since then the value of this threshold has been much debated because high grade prostate cancer has been found in people with levels below 4 µg/l.2

In their case-control study, Holmström and colleagues assessed the validity of PSA for . . . [Full text of this article]

Dragan Ilic, senior lecturer, Sally Green, professorial fellow

1 Monash Institute of Health Services Research, School of Public Health and Preventive Medicine, Monash University, Locked Bag 29, Monash Medical Centre, Clayton, Vic 3168, Australia

dragan.ilic@med.monash.edu.au


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Rapid Responses:

Read all Rapid Responses

PSA screening: Call a spade a spade!
Alain Braillon
bmj.com, 5 Oct 2009 [Full text]
Prostate Cancer and screening in the UK.
Robert Hunter
bmj.com, 16 Oct 2009 [Full text]
The PSA screening editorial defies the evidence
Charles J. Wright
bmj.com, 27 Nov 2009 [Full text]
Access jobs at BMJ Careers
Whats new online at Student BMJ