Low PSA and Prostate Cancer

Low PSA and prostate cancer are not mutually exclusive. Men with low PSA (prostate-specific antigen) levels on screening tests can still have prostate cancer. In a recently released study on low PSA and prostate cancer, the disease was detected by biopsy in men with normal PSA levels. However, the vast majority of these cases were low- and intermediate-grade cancers, which often are not clinically significant.

Low PSA and Prostate Cancer: An Overview

Men with low PSA (prostate-specific antigen) levels on screening tests can still have prostate cancer, according to a recently released study.
 
In this study, prostate cancers were detected by biopsy in men with normal PSA levels.
However, the vast majority of these cancers were of low and intermediate grade, which often are not clinically significant.
 
This was the first systematic study of men with PSA levels from 0 to 4 nanograms per milliliter (ng/ml). It shows that cancer of the prostate can be present in men with a "normal" PSA test. Doctors often use the value of 4.0 ng/ml or greater as the trigger for further investigation, such as a prostate biopsy. A PSA level below 4.0 is generally considered normal.
 

Low PSA and Prostate Cancer: Study Background

Prostate cancer clinicians often say that men are much more likely to die with prostate cancer than from it. According to recent autopsy studies, many men over age 50 have early, undiagnosed prostate cancer. Clinicians concur that most early cancers remain harmless, though some may progress to clinically significant disease.
 
Since the late 1980s, PSA tests have been widely used in the United States in an attempt to detect prostate cancer at an early stage. However, PSA testing has never been proven to reduce the risk of dying from prostate cancer. Not all prostate cancer detected by PSA screening is clinically relevant and, therefore, screening carries a risk of "over-diagnosing" the disease, which could lead to unnecessary surgery or radiation therapy. Thus, PSA testing is not a universally recommended screening procedure
 
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