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Value of a confirmatory PSA test in men undergoing screening for prostate cancer

Principal Investigator
Name
Amanda Black
Institution
NCI, DCEG, EBP
Email
About this CDAS Project
Study
PLCO (Learn more about this study)
Project ID
2008-0033
Initial CDAS Request Approval
Sep 26, 2008
Title
Value of a confirmatory PSA test in men undergoing screening for prostate cancer
Summary
PSA use in daily practice is complicated by certain conditions, such as prostatitis or benign prostatic hyperplasia (BPH), ejaculation, or medications, which are known to affect PSA levels. Consequently, although PSA screening for prostate cancer is commonplace, there is no standardized policy for the management of an elevated PSA. The PLCO trial defined a PSA level of >4ng/ml as abnormal but did not recommend a specific follow-up diagnostic algorithm. Men who had an abnormal PSA were referred to private physicians or health plans for follow-up. Potential follow-up pathways included; immediate biopsy, repeat PSA testing, or no further diagnostic follow up. Comparison of these follow-up algorithms may identify potential benefits and harms of repeating an abnormal PSA test and facilitate characterization of which patients, based on their levels and patterns of PSA elevation, might benefit from a repeat PSA test.
Aims

Our primary aims are to: 1. Describe the follow-up algorithms of men who had an abnormal PSA level, 2. Describe the diagnostic PSA results stratified by age and screening PSA level. 2. Compare the short-term prostate cancer outcomes (biopsy rate and the prostate cancer yield, stage and grade of each algorithm).

Collaborators

Daniel A. Barocas (Vanderbilt University Medical Center)
Robert Grubb (Wash U, St Louis, Missouri)
Jay H. Fowke (Vanderbilt University Medical Center)
Paul Pinsky (EDRG, NCI)

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