Prostate cancer screening: What is new?

From the Cleveland Clinic Journal of Medicine (CCJM):

PSA has low specificity. Most men with “elevated” PSA do not have prostate cancer.

There is no PSA level below which risk of cancer is zero. No PSA cutoff level is clinically useful.

PCPT risk calculator uses 7 variables to calculate the risk of having high-grade prostate cancer.

Men with a higher body mass index have lower PSA levels, statins also lower PSA levels.

Two large trials of PSA screening came to opposite conclusions in 2009: Europe vs. U.S. - benefit vs. no benefit.

New prostate cancer markers under study: Urinary PCA3, Serum EPCA-2, Gene fusions.

There is an ongoing debate whether 5-alpha reductase inhibitors should be used by all men at risk of prostate CA or only by those at high risk.

References:
What’s new in prostate cancer screening and prevention? CCJM, 2009.
Erectile dysfunction after prostate removal for prostate cancer
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