The chronobiology of prostate-specific antigen (PSA): case report and chrono-metaanalysis

The circadian profiles of circulating PSA of a 72-year-old man (FH) and of 11 other clinically relatively healthy men are compared. The time course of FH's PSA was also followed longitudinally with single samples for over 3 years. A transient peak in PSA exceeding the upper time-unspecified age-corrected reference limit prompted a retrospectively premature biopsy which indicated prostatitis. Watchful waiting and additional PSA determinations may be the preferred approach before biopsy, notably in the elderly, for reasons of cost and invasiveness of the procedure. The load associated with a biopsy is also evaluated by a cardiovascular response.