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PSA Thresholds for Prostate Cancer Detection FREE

Judd W. Moul, MD
JAMA. 1997;278(9):699-699. doi:10.1001/jama.1997.03550090023013
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To the Editor.  —I read with great interest the articles by Dr Catalona and colleagues1 and Dr Carter and colleagues2 regarding prostate-specific antigen (PSA) detection for prostate cancer. On one hand, Catalona et al found that the cancer detection rate was 22% when the screening PSA value was between 2.5 and 4.0 ng/mL and implied that vigilance was necessary in these men with lower PSA values. On the other hand, Carter et al found that considering as normal a PSA between 4.0 and 5.0 ng/mL maintains an acceptable ability to diagnose curable cancer and also suggested that men whose initial PSA level is less than 2.0 ng/mL may have screening every other year.Of great concern is that both studies lacked sufficient numbers of black men, who are known to have a higher prevalence of the disease and a propensity for more advanced cancer at diagnosis.3,4 With

REFERENCES

Catalona WJ, Smith DS, Ornstein DK.  Prostate cancer detection in men with serum PSA concentrations of 2.6 to 4.0 ng/mL and benign prostate examination: enhancement of specificity with free PSA measurements . JAMA . 1997;;277:1452-1455.
Carter HB, Epstein JI, Chan DW, Fozard JL, Pearson JD.  Recommended prostatespecific antigen testing intervals for the detection of curable prostate cancer . JAMA . 1997;;277:1456-1460.
Moul JW, Sesterhenn IA, Connelly RR, et al.  Prostate-specific antigen values at the time of prostate cancer diagnosis in African-American men . JAMA . 1995;;274:1277-1281.
Morgan TO, Jacobsen SJ, McCarthy WF, McLeod DG, Moul JW.  Age-specific reference ranges for prostate-specific antigen-based detection of prostate cancer in African American men . N Engl J Med . 1996;;335:304-310.

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Catalona WJ, Smith DS, Ornstein DK.  Prostate cancer detection in men with serum PSA concentrations of 2.6 to 4.0 ng/mL and benign prostate examination: enhancement of specificity with free PSA measurements . JAMA . 1997;;277:1452-1455.
Carter HB, Epstein JI, Chan DW, Fozard JL, Pearson JD.  Recommended prostatespecific antigen testing intervals for the detection of curable prostate cancer . JAMA . 1997;;277:1456-1460.
Moul JW, Sesterhenn IA, Connelly RR, et al.  Prostate-specific antigen values at the time of prostate cancer diagnosis in African-American men . JAMA . 1995;;274:1277-1281.
Morgan TO, Jacobsen SJ, McCarthy WF, McLeod DG, Moul JW.  Age-specific reference ranges for prostate-specific antigen-based detection of prostate cancer in African American men . N Engl J Med . 1996;;335:304-310.
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