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Prostate Cancer

Increase in PSA From Last Year

01/19/2010

Question:

My PSA went from 2.2 last March to 2.5 in December. How concerned should I be? Thank you.

Answer:

We assess the value of PSA as well as the rate of increase (also called the PSA velocity). PSA velocity is generally calculated on an annualized basis and guidelines typically indicate that PSA velocity of > 0.75 ng/ml/year raise concern regarding prostate cancer. PSA is sensitive (85% of men with prostate cancer have elevated PSA) but not specific (most men with elevated PSA do not have prostate cancer). Your PSA is not elevated and your PSA velocity is 0.4 ng/ml/year. Therefore, I would encourage you to continue PSA screening combined with annual digital rectal exam. Information regarding PSA and prostate cancer has to be correlated with age and risk factors which you and your physician should discuss.

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Response by:

James F Donovan, Jr, MD James F Donovan, Jr, MD
Professor of Surgery
Director of UC Urology
College of Medicine
University of Cincinnati