ALGORITHMS FOR EARLY DETECTION OF PROSTATE-CANCER - CURRENT STATE-OF-THE-ART

The common feature among algorithms currently available is that a low level of serum prostate specific antigen (PSA) (4 ng/ml or lower) associated with a normal digital rectal examination (DRE) indicates the need for neither a transrectal ultrasound (TRUS) examination nor biopsy, and a high level of serum PSA (higher than 10 ng/ml) indicates the need for a biopsy, regardless of DRE and TRUS findings. The unresolved problem is how to deal with men whose serum PSA levels are intermediately elevated (4.1-10 ng/ml). Whether PSA density, an age-adjusted reference range for PSA, or an age-adjusted reference range for PSA complement the PSA value alone has not been determined, and neither has the role of PSA velocity, which may hold more promise. This paper outlines the authors' recommendation for the early detection of prostate cancer and focuses on the obtainment of a baseline PSA level.