[Routine laboratory diagnostics of prostate cancer: Past, present and the future]

Prostate cancer is one of the most frequently occurring malignancies in men. It is increasingly recognized in patients above 40 years of age. The discovery of prostate-specific antigen (PSA) nearly 50 years ago and the subsequent capability to measure it on automated immunoassay platforms have led to a widespread use in laboratory diagnostics. However, the plethora of the elevated PSA values resulted in premature invasive treatments in several cases, so the term 'overdiagnosis of prostate cancer' has been created. Beside the classical total PSA test, several new methods have emerged in the past years that considerably enhanced the specificity of PSA-based diagnostics and this paved the way for more adequate clinical decisions. Some of these new and complex laboratory tests are not yet financed in Hungary, but the techniques are already available. In addition to the measurement of various proteins by immunoassays, large attention is devoted to molecular tests that not only help to establish the underlying pathophysiological process, but may also aid in determining the proper prognostic subgroup.