Prostate-specific antigen: the new early detection test for prostate cancer

Prostate cancer is the second leading cause of cancer deaths in men, affecting one in 11 men in the United States. Early detection in the preclinical stage offers the best chance of increased survival, decreased morbidity and possible cure. Prostate-specific-antigen assay is rapidly joining the digital rectal exam as the standard early detection test for prostate cancer because digital rectal exam alone is no longer considered adequate. The American Cancer Society now recommends an annual serum prostate-specific-antigen test for every man age 50 or older, and current evidence strongly suggests that combining the serum prostate-specific-antigen test with the digital rectal exam increases the early detection rate for prostate cancer. This article describes prostate-cancer screening guidelines, serum prostate-specific-antigen test interpretation and an algorithm for abnormal serum prostate-specific-antigen test follow-up.