Serum and Urine Biomarkers for Prostate Cancer: A Mini Review

Prostate cancer (PC) is the second most common cancer in men worldwide and is a leading cause of death. In India, following lung and oral cavity, prostate is the third most common site for cancer. Rapid urbanization, changing lifestyles, increasing longevity and improved access to healthcare facilities are rapidly changing the traditional notion that India has a low disease burden when it comes to PC. It is believed that India may not be much far behind western countries in PC epidemiology. For more than a couple of decades, Prostate Specific Antigen (PSA) was the only United States Food and Drug Administration (FDA) PC biomarker that was available. The advent of PSA completely revolutionized management of PC by facilitating early detection and reducing mortality rates. However, owing to its limitations of not being cancer specific, there was a need for developing newer biomarkers for PC. About a decade ago the FDA approved a serum based PC biomarker, Prostate Health Index (PHI) and a urinary biomarker Prostate Cancer Antigen (PCA3). Initially, FDA approved PC biomarkers were mostly based on biochemical parameters, however this changed a few years ago when they approved the 4-kallikrein Score (4k-score), which also makes use of clinical variables. This review focuses on these biomarkers.