Recent Increase in Unnecessary Prostate Biopsy

With an increase in attention given to PSA (prostate specific antigen) levels in men in the United States comes an increase in referrals for prostate biopsy. Oftentimes, these biopsies are recommended even when doctors have no other indications of prostate cancer besides the PSA level. A new study, however, finds that such prostate biopsies are unnecessary if men have a normal clinical exam and their total PSA levels are not yet high.

“If a man’s PSA has risen rapidly in recent years, there is no cause for concern if his total PSA level is still low and his clinical exam is normal,” said Andrew Vickers, PhD, the lead author of the new study from Memorial Sloan-Kettering Cancer Center.

In this most recent study, 5,519 men who participated in the Prostate Cancer Prevention trial were evaluated. All the participants were 55 years or older, had no previous history of prostate cancer, and had normal digital rectal findings and PSA levels of 3.0 ng/mL or less.

The men were randomly assigned to take either finasteride (a medication used to treat BPH) or placebo for seven years. Each year, all the men were screened for PSA levels, and those who had a PSA greater than 4.0 ng/mL were advised to have a prostate biopsy. At the end of the study, men who did not have prostate cancer were asked if they would consent to a biopsy.

The researchers concluded, after reviewing the study’s results, that the main factor that predicted the risk of cancer was a man’s PSA level, not how rapidly the PSA rose. Men with a steady PSA of 5 ng/mL were more likely to have prostate cancer than those whose PSA rose from 2.5 to 3.4 ng/mL. They recommended that a rapidly rising PSA should not be included in screening guidelines for prostate cancer.

3 Responses to “Recent Increase in Unnecessary Prostate Biopsy”

  1. Wonderful written content and wonderfully stated. Thanks.

  2. Clear and to the point. Looking forward to a lot more like this.

  3. I appreciate the factual written content and your energy and time you put into it. Looking forward to reading more from you.

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