PSA Density More Accurate Than PSA for Predicting Prostate Cancer

Prostate-specific antigen (PSA) density performed better than PSA above 4 ng/mL for detecting prostate cancer among a cohort of men undergoing prostate biopsy, according to a study published in Urology.¹

The aim of the study was to determine the predictive accuracy of PSA density compared with PSA ranges among men undergoing prostate biopsy.

The multicenter, prospective trial included 1290 men undergoing prostate biopsy. The PSA ranges that were evaluated were < 4 ng/mL, 4 to 10 ng/mL, and > 10 ng/mL.

Prostate cancer was diagnosed in 45% of participants; 22% had significant prostate cancer.

Detection of any prostate cancer was significantly higher with PSA density compared with PSA between 4 and 10 ng/mL (area under the curve [AUC], 0.70 vs 0.53, respectively; P < .0001) and > 10 ng/mL (AUC, 0.84 vs 0.65, respectively; P < .0001).

This benefit was evident in men with and without a previous history of biopsy, though particularly so among men with a previous negative biopsy.

The findings of this study suggest that PSA density has a better accuracy for detecting prostate cancer compared with PSA above 4 ng/mL.

Reference

1. Jue JS, Barboza MP, Prakash NS, et al. Re-examining PSA density: definng the optimal PSA range and patients for using PSA density to predict prostate cancer using extended template biopsy. Urology. 2017 April 18. doi: 10.1016/j.urology.2017.04.015 [Epub ahead of print]