Risk of Prostate Cancer Death Predicted with Single Blood Test
Researcher finds that a single PSA blood test at age 60 can predict the risk of death from prostate cancer up to 25 years. The findings are important for determining the risks and benefits of ongoing prostate cancer screening that can lead to unnecessary procedures and angst for men with elevated PSA levels.
PSA levels have been the standard for determining the presence of prostate cancer. Researchers now say PSA testing is a highly accurate measure of cancer risk, but baseline levels should determine who needs ongoing screening.
Scientists from Sloan Kettering analyzed blood samples from 1,167 men born in 1921, collected between 1981 and 1982. All of the men were followed until age 85 or until they died. The findings revealed that PSA levels can accurately predict who is at risk of dying from aggressive prostate cancer , and which men would develop symptoms even if they have the disease. .
Single PSA Level at age 60 Determines Risk of Dying from Prostate Cancer
Baseline PSA can be used to determine who should have ongoing screening. According to the results, men with baseline PSA levels above 2 ng/ml at age 60 should have ongoing blood tests and are at highest risk for aggressive forms of the disease.
The chances of dying from prostate cancer were 0.2 percent for men whose PSA levels were below 1 ng / ml. Over half of men fall in the low risk range say the authors. They also concluded that men with low PSA levels with prostate cancer would be unlikely to experience symptoms or shorten lifespan.
The authors write, "Men aged 60 with concentrations ≤1 ng/ml can be told that though they might have cancer, it is unlikely to become life threatening".
"This is a key finding," said Dr. Vickers. "We know that screening detects many prostate cancers that are not harmful, leading to anxiety and unnecessary treatment. It is our ability to determine the risk of the really aggressive cancers that makes this approach of such great potential value.”
Among the men studied, 90 percent of deaths occurred in men in the upper 25 percentile range of PSA levels at age 60. The men were part of the Malmö Preventive Project in Sweden that finds PSA can accurately predict the risk of dying from prostate cancer. A single PSA blood test at age 60 can determine a man's risk of dying from the disease, acording to the study.
BMJ 2010; 341:c4521