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The Prostate Cancer Intervention versus Observation Trial (PIVOT) randomized 731 men diagnosed with localized prostate cancer to radical prostatectomy or observation (mean age 67 years; median PSA 7.8 ng/ml). [10] In the observation group, bone metastases and prostate cancer death occurred in 10.6% and 8.4%, respectively through 12 years. [10]
THE PSA IS a good initial “check engine light” for the prostate, says Garrett Pohlman, M.D., a urologist and host of The Prostate Health Podcast. But it can just tell you that PSA levels are ...
PSA levels between 4 and 10 suggest you could have about a 25 percent chance of prostate cancer, and levels over 10 signal that your chance of having the cancer is more than 50 percent.
Men with high PSA levels are often recommended to repeat the blood test four to six weeks later, as PSA levels can fluctuate unrelated to prostate cancer. [17] Benign prostatic hyperplasia, prostate infection, recent ejaculation, and some urological procedures can increase PSA levels; taking 5α-reductase inhibitors can decrease PSA levels. [15]
However, checking blood PSA levels for prostate cancer screening is controversial and not necessarily indicated in every evaluation for BPH. [2] Benign prostatic hyperplasia and prostate cancer are both capable of increasing blood PSA levels and PSA elevation is unable to differentiate these two conditions well. [ 2 ]
PSA is not a unique indicator of prostate cancer, but may also detect prostatitis or benign prostatic hyperplasia. [16] A 2018 United States Preventive Services Task Force (USPSTF) recommendation adjusted the prior opposition to PSA screening, [17] suggesting shared decision-making regarding screening in healthy males 55 to 69 years of age. [17]
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