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William J. Catalona, MD; Deborah S. Smith, PhD
Washington University School of Medicine St Louis, Mo

JAMA. 1997;278(9):700-701.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—A PSA test should be viewed as a risk assessment for prostate cancer over a continuum of PSA values. Our article reported that (1) in the PSA range of 2.6 to 4.0 ng/mL, 22% of 317 volunteers with a benign-feeling prostate gland had cancer detected, and (2) measurement of percent-free PSA (%FPSA) could avoid 18% of the unnecessary biopsies while detecting 90% of cancers. These cancers would not be detected using traditional biopsy criteria. We hypothesize that earlier detection will result in improved outcomes. To this end, we are conducting longitudinal outcomes studies.

Dr Moul points out the contradiction that Carter et al¹ consider biannual testing sufficient in men with PSA levels less than 2.0 ng/mL and that diagnosing cancer at levels of 4.0 to 5.0 ng/mL is sufficient for detecting curable cancer, while we recommend biopsy in men with PSA levels higher than 2.6 ng/mL. Moul believes that . . . [Full Text PDF of this Article]

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