Prostate‐specific antigen: A review of the validation of the most commonly used cancer biomarker

Abstract

Objective To review the literature and collect expert advice for proposing preventive and curative treatments of mouth and dental involvement in patients with systemic sclerosis (SSc; scleroderma). Methods The literature pertaining to mouth and/or dental involvement related to SSc was reviewed, and recommendations were developed according to the suggestions of a French multidisciplinary working group of experts and validated by a lecture committee. Results Dentists face 3 main issues in caring for SSc patients: oral mucosa involvement, manducatory apparatus and mouth involvement responsible for limitations in mouth opening, and treatment‐related adverse events. An increased risk of tongue carcinoma has been noted. In patients with severe limitation in mouth opening (<30 mm), recommended treatments are a specific mouth‐opening rehabilitation program, flexible sectional dentures, and splint therapy. Indications for dental implants depend on the severity of SSc, comorbidities, and/or ongoing bisphosphonate treatment. Prevention of mouth infections and caries implies patient education and teaching about mouth and dental hygiene, periodontal maintenance, and treatment of sicca syndrome. Cessation of tobacco use is mandatory. Patient‐tailored rehabilitation may improve limitations in mouth opening. Systematic dental panoramic radiography allows for the early detection of dental caries. Conclusion Prevention of oral and dental complications is a major issue in patients with SSc. Dental treatment should be tailored to limitations in mouth opening, disease severity, and ongoing treatments.

Prostate cancer incidence among American Indian and Alaska Native men, US, 1999-2004

“…First, PSA screening primarily detects early-stage cancers. 24 Many screen-detected early stage prostate cancers are indolent, non-life-threatening lesions that would not have become clinically apparent in the absence of screening. 25 Therefore, a lower prevalence of prostate cancer screening will result in lower incidence rates.…”

Methylated genes as new cancer biomarkers

“…Indeed, elevated serum levels of PSA are now the most common initial event leading to the diagnosis of prostate cancer. 59 Because of limited specificity and sensitivity, PSA, however, is a non-ideal screening test for prostate cancer. 60 A frequent molecular alteration in prostate cancer is hypermethylation in the promoter region of the glutathione-S-transferase P1 (GSTP1) gene.…”

New circulating biomarkers for prostate cancer

“…Consequently, the upper limit of normality of 4.0 ng ml À1 , that was set in initial studies, may no longer be optimal since it has been proven that a significant number of cancers remained undetected in patients with PSA levels below this cutoff point. 3,17 Initial reports suggested that men with a slightly 'abnormal' value (4.0-9.9 ng ml À1 ) had a 22% chance of having PCa, and those with a significant rise of 410.0 ng ml À1 had a 67% risk. 18 However, it became quickly clear that these relative risks were in context of a sextant biopsy technique fraught with a high falsenegative detection rate, and that the risk of harboring PCa in men with a PSA level above 4.0 was approximately twice as likely, in the 40-50% range.…”