PSA testing can predict advanced prostate cancer

A single PSA test taken before the age 50 years can be used to predict advanced prostate cancer in men up to 25 years in advance of a diagnosis, according to a study by researchers at Memorial Sloan-Kettering Cancer Center in New York and Lund University in Sweden. The findings, published in the online journal BMC Medicine, should help physicians identify men who would benefit from intensive prostate cancer screenings over their lifetime.

Previously, the researchers showed that a single PSA test at age 50 or younger could predict the presence of prostate cancer in men up to 25 years in advance of diagnosis.

“This latest study is a unique, natural experiment to test whether we can predict advanced prostate cancer many years before it is diagnosed,” said lead author Hans Lilja, MD, PhD, of Sloan-Kettering.

Blood samples collected between 1974 and 1986 as part of a large, population-based study of middle-age men called the Malmö Preventative Medicine study were analyzed. The study cohort included 161 men who had been diagnosed with advanced prostate cancer by 1999 and men of a similar age who had not developed cancer by that time.

Results showed that the total PSA level was an accurate predictor of advanced cancer diagnosis in men later in life. Sixty-six percent of advanced cancers were seen in men whose PSA levels were in the top 20% (total PSA >0.9 ng/mL). The average length of time from blood test to cancer diagnosis was 17 years.

Findings suggest the possibility of using an early PSA test to determine which men should be the focus of the most intensive screening efforts, Dr. Lilja said.