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Evolution of Prostate-Specific Antigen for Screening

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Prostate Cancer Screening

Part of the book series: Current Clinical Urology ((CCU))

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Summary

Prostate-specific antigen (PSA) is one of the most widely applied screening tests in current medical practice. Its widespread use has had a tremendous impact on all aspects of the management of prostate cancer. PSA screening has led to a stage migration to more organ-confined cancers at the time of diagnosis and is temporally associated with a decrease in prostate cancer mortality. However, PSA screening is imperfect and remains controversial. In this chapter we review the history of the discovery, initial studies, and subsequent widespread application of PSA screening. Initial studies were limited by the lack of applicability to all ethnic groups, upper limits of normal determined with incomplete ascertainment of disease status among study participants, and obsolete biopsy techniques. Various modifications of PSA-based screening have been adopted clinically without sufficient validation. More recent studies have elucidated the non-dichotomous nature of PSA as well as the contribution of other factors to the overall risk for prostate cancer. We await the results of large-scale clinical trials that will more clearly define the impact of PSA screening on prostate cancer mortality as well as the discovery and validation of additional prognostic biomarkers.

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Authors and Affiliations

  1. Brooke Army Medical Center, Fort Sam Houston, TX, USA

    Javier Hernandez MD, MS

  2. Wilford Hall Medical Center, Lackland AFB, San Antonio, TX, USA

    Edith Canby-Hagino MD, MS

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  1. Javier Hernandez MD, MS
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  2. Edith Canby-Hagino MD, MS
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Editors and Affiliations

  1. Department of Mathematics, Technical University, Garching, Germany

    Donna P. Ankerst Ph.D. (Professor) (Professor)

  2. Associate Professor, Departments of Urology, and Epidemiology/Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    Donna P. Ankerst Ph.D. (Professor) (Professor)

  3. Member, Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, UK

    Catherine M. Tangen DrPh

  4. Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    Ian M. Thompson Jr MD (Professor and Chair) (Professor and Chair)

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© 2009 Humana Press, a part of Springer Science+Business Media, LLC

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Hernandez, J., Canby-Hagino, E. (2009). Evolution of Prostate-Specific Antigen for Screening. In: Ankerst, D.P., Tangen, C.M., Thompson, I.M. (eds) Prostate Cancer Screening. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-60327-281-0_5

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  • DOI: https://doi.org/10.1007/978-1-60327-281-0_5

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60327-280-3

  • Online ISBN: 978-1-60327-281-0

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