Current Prostate Reports

, Volume 5, Issue 1, pp 13–17 | Cite as

Prostate cancer detection strategies

  • Timothy C. Brand
  • Javier Hernandez
  • Edith D. Canby-Hagino
  • Joseph W. Basler
  • Ian M. Thompson


Prostate cancer is the most common malignancy in men and, as a result, there has been a nationwide emphasis on screening and detection. With the widespread use of the prostate-specific antigen (PSA), prostate cancer screening effectively detects localized prostate cancer. However, recent reports have identified a significant proportion of prostate cancer in men with low PSA levels. Many of these cancers are higher-grade malignancies. Consequently, PSA may function more effectively as a screening tool when applied over a continuum that is associated with degree of risk, rather than a binary measure. Other markers are currently being investigated. Ideally, a marker will identify the malignancy that is a clinical threat, thereby avoiding intervention for indolent disease. Prevention strategies may be employed for higher-risk patients, and these strategies eventually may be tailored to genetic or other risks.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Jemal A, Murray T, Ward E, et al.: Cancer statistics, 2005. CA Cancer J Clin 2005, 55:10–30.PubMedCrossRefGoogle Scholar
  2. 2.
    Thompson I, Tangen C, Tolcher A, et al.: Association of African-American ethnic background with survival in men with metastatic prostate cancer [see comment]. J Natl Cancer Inst 2001, 93:219–225.PubMedCrossRefGoogle Scholar
  3. 3.
    McDavid K, Lee J, Fulton JP, et al.: Prostate cancer incidence and mortality rates and trends in the United States and Canada. Public Health Rep 2004, 119:174–186.PubMedGoogle Scholar
  4. 4.
    Edwards BK, Brown ML, Wingo PA, et al.: Annual report to the nation on the status of cancer, 1975–2002, featuring population-based trends in cancer treatment. J Natl Cancer Inst 2005, 97:1407–1427.PubMedCrossRefGoogle Scholar
  5. 5.
    Surveillance Epidemiology and End Results. Edited by US National Institute of Health, 2005. Accessed March 8, 2006.Google Scholar
  6. 6.
    Kuriyama M, Takeuchi T, Okano M, et al.: [A normal value of serum prostate antigen in Japanese males and its comparison with Americans]. Nippon Hinyokika Gakkai Zasshi 1984, 75:802–806.PubMedGoogle Scholar
  7. 7.
    Chodak GW, Schoenberg HW: Early detection of prostate cancer by routine screening. JAMA 1984, 252:3261–3264.PubMedCrossRefGoogle Scholar
  8. 8.
    Ablin RJ, Bronson P, Soanes WA, Witebsky E: Tissue-and species-specific antigens of normal human prostatic tissue. J Immunol 1970, 104:1329–1339.PubMedGoogle Scholar
  9. 9.
    Ablin RJ, Soanes WA, Bronson P, Witebsky E: Precipitating antigens of the normal human prostate. J Reprod Fertil 1970, 22:573–574.PubMedCrossRefGoogle Scholar
  10. 10.
    Kobayashi T, Nishizawa K, Ogura K, et al.: Detection of prostate cancer in men with prostate-specific antigen levels of 2.0 to 4.0 ng/mL equivalent to that in men with 4.1 to 10.0 ng/mL in a Japanese population. Urology 2004, 63:727–731.PubMedCrossRefGoogle Scholar
  11. 11.
    Babaian RJ, Johnston DA, Naccarato W, et al.: The incidence of prostate cancer in a screening population with a serum prostate-specific antigen between 2.5 and 4.0 ng/mL: relation to biopsy strategy. J Urol 2001, 165:757–760.PubMedCrossRefGoogle Scholar
  12. 12.
    Hakama M, Stenman UH, Aromaa A, et al.: Validity of the prostate-specific antigen test for prostate cancer screening: follow-up study with a bank of 21,000 sera in Finland. J Urol 2001, 166:2189–2192.PubMedCrossRefGoogle Scholar
  13. 13.
    Recker F, Kwiatkowski MK, Huber A, et al.: Prospective detection of clinically relevant prostate cancer in the prostate-specific antigen range 1 to 3 ng./mL. combined with free-to-total ratio 20% or less: the Aarau experience. J Urol 2001, 166:851–855.PubMedCrossRefGoogle Scholar
  14. 14.
    Thompson IM, Goodman PJ, Tangen CM, et al.: The influence of finasteride on the development of prostate cancer [see comment]. N Engl J Med 2003, 349:215–224.PubMedCrossRefGoogle Scholar
  15. 15.
    Thompson IM, Pauler DK, Goodman PJ, et al.: Prevalence of prostate cancer among men with a prostate-specific antigen level < or = 4.0 ng per milliliter [see comment]. N Engl J Med 2004, 350:2239–2246 [Erratum appears in N Engl J Med 2004, 351:1470].PubMedCrossRefGoogle Scholar
  16. 16.
    Stamey TA, Yang N, Hay AR, et al.: Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med 1987, 317:909–916.PubMedCrossRefGoogle Scholar
  17. 17.
    Stamey TA: The era of serum prostate-specific antigen as a marker for biopsy of the prostate and detecting prostate cancer is now over in the USA. BJU Int 2004, 94:963–964.PubMedCrossRefGoogle Scholar
  18. 18.
    Stamey TA, Caldwell M, McNeal JE, et al.: The prostate-specific antigen era in the United States is over for prostate cancer: What happened in the last 20 years? J Urol 2004, 172:1297–1301.PubMedCrossRefGoogle Scholar
  19. 19.
    Carter HB, Pearson JD, Metter EJ, et al.: Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease [see comment]. JAMA 1992, 267:2215–2220.PubMedCrossRefGoogle Scholar
  20. 20.
    Benson MC, Whang IS, Olsson CA, et al.: The use of prostate-specific antigen density to enhance the predictive value of intermediate levels of serum prostate-specific antigen. J Urol 1992, 147:817–821.PubMedGoogle Scholar
  21. 21.
    Oesterling JE, Jacobsen SJ, Chute CG, et al.: Serum prostate-specific antigen in a community-based population of healthy men: establishment of age-specific reference ranges [see comment]. JAMA 1993, 270:860–864.PubMedCrossRefGoogle Scholar
  22. 22.
    Partin AW, Catalona WJ, Southwick PC, et al.: Analysis of percent-free prostate-specific antigen (PSA) for prostate cancer detection: influence of total PSA, prostate volume, and age. Urology 1996, 48:55–61.PubMedCrossRefGoogle Scholar
  23. 23.
    Brawer MK, Beatie J, Wener MH, et al.: Screening for prostatic carcinoma with prostate-specific antigen: results of the second year. J Urol 1993, 150:106–109.PubMedGoogle Scholar
  24. 24.
    Brawer MK, Chetner MP, Beatie J, et al.: Screening for prostatic carcinoma with prostate-specific antigen. J Urol 1992, 147:841–845.PubMedGoogle Scholar
  25. 25.
    Catalona WJ, Smith DS, Ratliff TL, et al.: Measurement of prostate-specific antigen in serum as a screening test for prostate cancer [see comment]. N Engl J Med 1991, 324:1156–1161 [Erratum appears in N Engl J Med 1991, 325:1324].PubMedCrossRefGoogle Scholar
  26. 26.
    Cooner WH, Mosley BR, Rutherford CL Jr, et al.: Prostate cancer detection in a clinical urological practice by ultrasonography, digital rectal examination, and prostate-specific antigen. J Urol 1990, 143:1146–1152; discussion 1152–1144.PubMedGoogle Scholar
  27. 27.
    Terris MK, Stamey TA: Utilization of polyclonal serum prostate-specific antigen levels in screening for prostate cancer: a comparison with corresponding monoclonal values. Br J Urol 1994, 73:61–64.PubMedCrossRefGoogle Scholar
  28. 28.
    Hodge KK, McNeal JE, Terris MK, Stamey TA: Random systematic versus directed ultrasound-guided transrectal core biopsies of the prostate. J Urol 1989, 142:71–75.PubMedGoogle Scholar
  29. 29.
    Hernandez J, Thompson IM: Prostate-specific antigen: a review of the validation of the most commonly used cancer biomarker. Cancer 2004, 101:894–904.PubMedCrossRefGoogle Scholar
  30. 30.
    Thompson IM, Ankerst DP, Chi C, et al.: Operating characteristics of prostate-specific antigen in men with an initial PSA level of 3.0 ng/ml or lower. JAMA 2005, 294:66–70.PubMedCrossRefGoogle Scholar
  31. 31.
    Holmes EH: PSMA-specific antibodies and their diagnostic and therapeutic use. Expert Opin Investig Drugs 2001, 10:511–519.PubMedCrossRefGoogle Scholar
  32. 32.
    Troyer JK, Beckett ML, Wright GL Jr: Detection and characterization of the prostate-specific membrane antigen (PSMA) in tissue extracts and body fluids. Int J Cancer 1995, 62:552–558.PubMedCrossRefGoogle Scholar
  33. 33.
    Manyak MJ, Hinkle GH, Olsen JO, et al.: Immunoscintigraphy with indium-111-capromab pendetide: evaluation before definitive therapy in patients with prostate cancer. Urology 1999, 54:1058–1063.PubMedCrossRefGoogle Scholar
  34. 34.
    Babaian RJ, Sayer J, Podoloff DA, et al.: Radioimmunoscintigraphy of pelvic lymph nodes with 111indium-labeled monoclonal antibody CYT-356. J Urol 1994, 152:1952–1955.PubMedGoogle Scholar
  35. 35.
    Bermejo CE, Coursey J, Basler J, et al.: Histologic confirmation of lesions identified by Prostascint scan following definitive treatment. Urol Oncol 2003, 21:349–353.PubMedCrossRefGoogle Scholar
  36. 36.
    Fradet Y, Saad F, Aprikian A, et al.: uPM3, a new molecular urine test for the detection of prostate cancer. Urology 2004, 64:311–316.PubMedCrossRefGoogle Scholar
  37. 37.
    Brawn PN, Johnson EH, Kuhl DL, et al.: Stage at presentation and survival of white and black patients with prostate carcinoma. Cancer 1993, 71:2569–2573.PubMedCrossRefGoogle Scholar
  38. 38.
    Hoffman RM, Gilliland FD, Eley JW, et al.: Racial and ethnic differences in advanced-stage prostate cancer: the Prostate Cancer Outcomes Study. J Natl Cancer Inst 2001, 93:388–395.PubMedCrossRefGoogle Scholar
  39. 39.
    Powell IJ: Prostate cancer in the African American: Is this a different disease? Semin Urol Oncol 1998, 16:221–226.PubMedGoogle Scholar
  40. 40.
    Stanford JL, Ostrander EA: Familial prostate cancer. Epidemiol Rev 2001, 23:19–23.PubMedCrossRefGoogle Scholar
  41. 41.
    Lichtenstein P, Holm NV, Verkasalo PK, et al.: Environmental and heritable factors in the causation of cancer: analyses of cohorts of twins from Sweden, Denmark, and Finland [see comment]. N Engl J Med 2000, 343:78–85.PubMedCrossRefGoogle Scholar
  42. 42.
    Gonzalgo ML, Isaacs WB: Molecular pathways to prostate cancer. J Urol 2003, 170:2444–2452.PubMedCrossRefGoogle Scholar
  43. 43.
    Hsing AW, Chokkalingam AP, Gao YT, et al.: Polymorphic CAG/CAA repeat length in the AIB1/SRC-3 gene and prostate cancer risk: a population-based case-control study. Cancer Epidemiol Biomarkers Prev 2002, 11:337–341.PubMedGoogle Scholar
  44. 44.
    Nam RK, Elhaji Y, Krahn MD, et al.: Significance of the CAG repeat polymorphism of the androgen receptor gene in prostate cancer progression. J Urol 2000, 164:567–572.PubMedCrossRefGoogle Scholar
  45. 45.
    Giovannucci E, Stampfer MJ, Krithivas K, et al.: The CAG repeat within the androgen receptor gene and its relationship to prostate cancer. Proc Natl Acad Sci U S A 1997, 94:3320–3323 [Erratum appears in Proc Natl Acad Sci U S A 1997, 94:8272].PubMedCrossRefGoogle Scholar
  46. 46.
    Makridakis NM, di Salle E, Reichardt JK: Biochemical and pharmacogenetic dissection of human steroid 5 alpha-reductase type II. Pharmacogenetics 2000, 10:407–413.PubMedCrossRefGoogle Scholar
  47. 47.
    Rebbeck TR: More about: modification of clinical presentation of prostate tumors by a novel genetic variant in CYP3A4. J Natl Cancer Inst 2000, 92:76.PubMedCrossRefGoogle Scholar
  48. 48.
    Walker AH, Jaffe JM, Gunasegaram S, et al.: Characterization of an allelic variant in the nifedipine-specific element of CYP3A4: ethnic distribution and implications for prostate cancer risk. Mutations in brief no. 191. Online. Hum Mutat 1998, 12:289.PubMedGoogle Scholar
  49. 49.
    Ingles SA, Coetzee GA, Ross RK, et al.: Association of prostate cancer with vitamin D receptor haplotypes in African-Americans. Cancer Res 1998, 58:1620–1623.PubMedGoogle Scholar
  50. 50.
    Kibel AS, Isaacs SD, Isaacs WB, Bova GS: Vitamin D receptor polymorphisms and lethal prostate cancer. J Urol 1998, 160:1405–1409.PubMedCrossRefGoogle Scholar
  51. 51.
    Beer TM, Evans AJ, Hough KM, et al.: Polymorphisms of GSTP1 and related genes and prostate cancer risk. Prostate Cancer Prostatic Dis 2002, 5:22–27.PubMedCrossRefGoogle Scholar
  52. 52.
    Verma M, Srivastava S: New cancer biomarkers deriving from NCI early detection research. Recent Results Cancer Res 2003, 163:72–84; discussion 264–266.PubMedCrossRefGoogle Scholar
  53. 53.
    Zheng Y, Xu Y, Ye B, et al.: Prostate carcinoma tissue proteomics for biomarker discovery. Cancer 2003, 98:2576–2582.PubMedCrossRefGoogle Scholar
  54. 54.
    Cazares LH, Adam BL, Ward MD, et al.: Normal, benign, preneoplastic, and malignant prostate cells have distinct protein expression profiles resolved by surface enhanced laser desorption/ionization mass spectrometry. Clin Cancer Res 2002, 8:2541–2552.PubMedGoogle Scholar
  55. 55.
    Grizzle WE, Semmes OJ, Basler J, et al.: The early detection research network surface-enhanced laser desorption and ionization prostate cancer detection study: a study in biomarker validation in genitourinary oncology. Urol Oncol 2004, 22:337–343.PubMedCrossRefGoogle Scholar
  56. 56.
    Ardekani AM, Liotta LA, Petricoin EF 3rd: Clinical potential of proteomics in the diagnosis of ovarian cancer. Expert Rev Mol Diagn 2002, 2:312–320.PubMedCrossRefGoogle Scholar
  57. 57.
    Oesterling JE, Chan DW, Epstein JI, et al.: Prostate-specific antigen in the preoperative and postoperative evaluation of localized prostatic cancer treated with radical prostatectomy. J Urol 1988, 139:766–772.PubMedGoogle Scholar
  58. 58.
    Li J, Zhang Z, Rosenzweig J, et al.: Proteomics and bioinformatics approaches for identification of serum biomarkers to detect breast cancer. Clin Chem 2002, 48:1296–1304.PubMedGoogle Scholar
  59. 59.
    Zhukov TA, Johanson RA, Cantor AB, et al.: Discovery of distinct protein profiles specific for lung tumors and premalignant lung lesions by SELDI mass spectrometry. Lung Cancer 2003, 40:267–279.PubMedCrossRefGoogle Scholar
  60. 60.
    Banez LL, Prasanna P, Sun L, et al.: Diagnostic potential of serum proteomic patterns in prostate cancer [see comment]. J Urol 2003, 170:442–446.PubMedCrossRefGoogle Scholar

Copyright information

© Current Medicine Group LLC 2007

Authors and Affiliations

  • Timothy C. Brand
    • 1
  • Javier Hernandez
  • Edith D. Canby-Hagino
  • Joseph W. Basler
  • Ian M. Thompson
  1. 1.Department of UrologyUniversity of Texas Health Science CenterSan AntonioUSA

Personalised recommendations