PSA Testing Do-Overs

If your doctor suspects you may have prostate cancer because of an elevated prostate-specific antigen (PSA) level, you might want to ask for a repeat PSA test to confirm the results, says a new Canadian study. It could save you from undergoing an unnecessary prostate biopsy that could entail serious complications. Of 1,268 men who underwent a second PSA test within three months of their first test showing elevated PSA levels, 315 (24.8%) had normal results the second time around. As a result of their findings, the researchers recommend that men with elevated PSA levels should repeat the test before undergoing a biopsy. Elevated PSA levels might result from infection, physical activity or sexual activity. The American Urological Association already recommends that the decision to undergo a biopsy shouldn’t be based on a single PSA test result. However, other studies reveal that only 16 to 56 percent of primary care physicians ordered a repeat test for patients with abnormal results. Most experts agree that PSA screening should be used with a digital rectal examination and additional information such as family history, race and age to assess the likelihood of prostate cancer being present. The PSA test should be performed following a discussion with the patient about its benefits and risks.

(The above was published in the Mayo Clinic Proceedings, 2015.)

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