Prostate-Specific Antigen Levels Among Participants Receiving Annual Testing

What are the implications of repeating a prostate-specific antigen (PSA) test in men with an elevated result before further workup?In this cohort study of 11 176 men aged 54 to 75 years who were enrolled in the screening group of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, 22% of PSA measurements above 2.5 ng/mL fell below that threshold within a year; similar results were observed at 3 and 4 ng/mL. A risk stratification model using PSA history identified that patients with persistently elevated PSA had a low (<10%) likelihood of decrease below the threshold.These findings suggest the utility of guideline recommendations to confirm elevated PSA results in most patients; however, patients with a consistent pattern of elevated PSA values should proceed to further diagnostic evaluation without repeat testing.

Corresponding Author: Sigrid V. Carlsson, MD, PhD, MPH, Department of Surgery (Urology Service) and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, Josie Robertson Surgery Center, 1133 York Ave, New York, NY 10065 (carlssos@mskcc.org).

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