Pretreatment PSA Velocity and Risk of Death From Prostate Cancer Following External Beam Radiation Therapy

Abstract

The impact of prostate-specific antigen (PSA) screening on mortality remains under study,^1,2 but since the introduction of PSA testing the presentation of prostate cancer has shifted toward younger men with less aggressive and smaller-volume disease.^3,4 Concomitant with stage migration the median PSA level at presentation has also decreased such that PSA levels greater than 10.0 ng/mL at diagnosis have become infrequent.⁵ Moreover, benign prostatic hypertrophy increases serum PSA levels and is commonly seen in men of prostate cancer–bearing age. As a result, the prognostic significance of any single value of PSA below 10.0 ng/mL is becoming more limited.