The German guidelines for early detection of prostate cancer propose the use of digital rectal palpation and prostate specific antigen (PSA). PSA levels above 4 mg/L are considered to be suspect. However, method comparison of six different assays resulted in differences up to 20% in the range of 4 mg/L, although all assays used the Stanford 90/10 (WHO 96/670) calibration. Interpretation of PSA levels therefore has to take into consideration assay-specific characteristics, using assay-specific local reference ranges. However, the estimation of reference ranges by, e.g., analysis of frequency distribution failed with regard to the high prevalence of benign prostate hyperplasia. PSA velocity is proposed for early detection. Interpretation of PSA velocity especially at low PSA levels has to take into consideration analytical imprecision and biological variation.
The German guidelines for early detection of prostate cancer propose the use of digital rectal palpation and prostate specific antigen (PSA). PSA levels above 4 mg/L are considered to be suspect. However, method comparison of six different assays resulted in differences up to 20% in the range of 4 mg/L, although all assays used the Stanford 90/10 (WHO 96/670) calibration. Interpretation of PSA levels therefore has to take into consideration assay-specific characteristics, using assay-specific local reference ranges. However, the estimation of reference ranges by, e.g., analysis of frequency distribution failed with regard to the high prevalence of benign prostate hyperplasia. PSA velocity is proposed for early detection. Interpretation of PSA velocity especially at low PSA levels has to take into consideration analytical imprecision and biological variation.
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