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LETTERS: Alain Braillon and Gérard Dubois Unacceptable in the under 50s BMJ 2007; 335: 1225 [Full text]

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PSA is a valuable test in a 40 year old

Godon Rafool   (14 December 2007)

PSA is a valuable test in a 40 year old 14 December 2007
Godon Rafool, Medical Doctor Winter Haven,FL 33881 USA Send response to journal: Re: PSA is a valuable test in a 40 year old	There sre at least 2 circumstances that a PSA is valuable in the under 50. Any patient who has a first degree relative with prostate cancer should have a PSA test done in their 40'. They should also have a DRE done as well. Another and very important reason, a recent study done by Hans Lilja,MD,PhD. an attending research clinical chemist at Memorial Sloan- Kittering Cancer Center in New York detailed how a single PSA test given to more than 21,000 men in there early 40's was highly predictive of their developing advanced cancers that developed over a 25 year period were associated with PSA values in the 80th percentile or greater among men between the ages of 44 and 50. His study showed that a PSA of 0.5ng/ml at the time of sampling had a 2% liklihood of developing advanced prostate cancer years later. However if the original PSA was 2 ng/ml or higher the risk of advanced cancer was 12%. This study will provide physicians with a better tool to decide what course of treatment should be offered to the patient with early diagnosed proatate cancer. "PSA screening is the most common way that prostate cancer is detected in the United States." This quote is not only mine but Jareck L. Mostwin medical editor of the Johns Hopkins prostate Bulletin. Competing interests: None declared