Personalizing prostate specific antigen testing may improve specificity, reduce biopsies

April 15, 2013

Genetic variants have been identified which can increase serum prostate specific antigen (PSA) concentrations and prostate cancer risk. A new study published in The Journal of Urology reports that correcting PSA levels for these genetic variants can have significant consequences, including avoiding unnecessary biopsies for some men and eliminating false complacency for others.

In this study of 964 healthy , correcting individual for these genetic variants led to an 18.3 percent reduction in the number of men who initially had a measured serum PSA above the biopsy criteria, but whose adjusted PSA fell below the cutoff value. The latter group would have likely undergone what would have been an unnecessary biopsy. Conversely, genetic correction led to PSA levels moving from below threshold to above threshold for 3.4 percent of the men, thus sending out an alert for further investigation.

"If our results are validated, adjustment for the four PSA single (SNPs) could potentially prevent up to 15 percent to 20 percent of prostate biopsies. Since it has been estimated that more than 1 million biopsies are performed in the United States annually, this could translate into 150,000 to 200,000 potentially unnecessary biopsies every year," says William J. Catalona, MD, professor of urology at the Feinberg School of Medicine of Northwestern University. In addition to cost savings, fewer biopsies mean fewer adverse outcomes, such as infection, sepsis, and hospitalization.

For 98 percent of the men, genetic adjustment of PSA levels did not change outcome. However, genetic correction was important for the 17 men who were reclassified as no longer meeting biopsy criteria of PSA 2.5 ng/ml or greater and the three whose condition was up classified. The results suggest that traditional single cutoff PSA screening levels of 2.5 ng/ml or greater or 4.0 ng/ml or greater should be personalized to reflect an individual's genetic make-up.

"If confirmed, this approach could potentially be used to tailor , possibly reducing unnecessary biopsies and avoiding delay in performing necessary biopsies," concludes Dr. Catalona and his co-investigators.

Explore further: When rising PSA means prostate cancer is in patient's future

More information: "Personalized prostate specific antigen testing using genetic variants may reduce unnecessary prostate biopsies," by Brian T. Helfand, Stacy Loeb, Qiaoyan Hu, Phillip R. Cooper, Kimberly A. Roehl, Barry B. McGuire, Nikola A. Baumann and William J. Catalona. DOI: dx.doi.org/10.1016/j.juro.2012.12.023. The Journal of Urology, Volume 189, Issue 5 (May 2013)

Related Stories

When rising PSA means prostate cancer is in patient's future

May 18, 2011
A man's rising PSA (prostate-specific antigen) level over several years – which had been seen as a possible warning sign of prostate cancer – has recently come under fire as a screening test because it sometimes ...

New prostate cancer test gives more accurate diagnosis

April 6, 2011
In a large multi-center clinical trial, a new PSA test to screen for prostate cancer more accurately identified men with prostate cancer -- particularly the aggressive form of the disease -- and substantially reduced false ...

Alternative PSA screening strategies could reduce harm

February 5, 2013
(HealthDay)—Compared with standard screening, alternative prostate-specific antigen (PSA) screening strategies could maintain good prostate cancer detection rates while reducing overdiagnoses and unnecessary biopsies, according ...

Genetic test may reduce need for repeat biopsy for prostate cancer

July 18, 2012
Karim Kader, MD, PhD, associate clinical professor at the UC San Diego School of Medicine, together with a team of researchers from Wake Forest University School of Medicine, have developed a genetic test to predict a man’s ...

Recommended for you

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

Novel CRISPR-Cas9 screening enables discovery of new targets to aid cancer immunotherapy

July 19, 2017
A novel screening method developed by a team at Dana-Farber/Boston Children's Cancer and Blood Disorders Center—using CRISPR-Cas9 genome editing technology to test the function of thousands of tumor genes in mice—has ...

Combining CAR T cells with existing immunotherapies may overcome resistance in glioblastomas

July 19, 2017
Genetically modified "hunter" T cells successfully migrated to and penetrated a deadly type of brain tumor known as glioblastoma (GBM) in a clinical trial of the new therapy, but the cells triggered an immunosuppressive tumor ...

How CD44s gives brain cancer a survival advantage

July 19, 2017
Understanding the mechanisms that give cancer cells the ability to survive and grow opens the possibility of developing improved treatments to control or cure the disease. In the case of glioblastoma multiforme, the deadliest ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.