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Review
. 2015 Jan;25(1):59-64.
doi: 10.1097/MOU.0000000000000128.

Serum markers in prostate cancer detection

Ola Bratt  1 , Hans Lilja
Affiliations
Review

Serum markers in prostate cancer detection

Ola Bratt et al. Curr Opin Urol. 2015 Jan.

Abstract

Purpose of review: Prostate-specific antigen (PSA) testing provides significant benefits by reducing prostate cancer mortality, but also leads to important harms by detecting clinically insignificant cancers. Hence, there are urgent needs for complementary tools for middle-aged men with modest PSA elevations in blood. This review includes research on prostate cancer biomarkers in blood published from March 2013 through August 2014.

Recent findings: Research progress has been made mainly on PSA as a predictive marker and in the field of kallikrein-based tests: [-2] proPSA, the prostate health index, and a panel of four kallikrein markers. As men with PSA levels below age-median are at very low 20-year risk of metastatic prostate cancer, individualized screening intervals, based on PSA levels, may help in reducing screening costs, prostate biopsies, and detection of insignificant cancer. Statistical models based on kallikrein-markers in blood improve the specificity at modestly elevated PSA (2-10 ng/ml), eliminate unnecessary biopsies, and help selecting men at risk of significant prostate cancer for biopsy or imaging.

Summary: Individualized, risk-adapted PSA testing intervals and reflex-testing of kallikrein-markers for men with modestly increased PSA values may decrease the harms of screening. However, the clinical value of the proposed testing algorithms and additional tests awaits definitive confirmation in prospective trials.

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Conflict of interest statement

Conflict of interest

Hans Lilja holds patents for free PSA, kallikrein related peptidase 2, and intact PSA assays, and along with AV, is named as co-inventor on a patent application for intact/nicked PSA assays and for a statistical method for predicting the result of a prostate biopsy. Ola Bratt has no conflicts of interest.

References

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