Prostate-specific antigen (PSA) is the most accurate and preferred serum marker for the early detection and monitoring of prostate cancer (PCa). Although excellent, PSA is not the perfect tumor marker because of its limitations in sensitivity and specificity, especially for high normal or mildly elevated levels. In an effort to improve the clinical utility of the PSA test, new concepts have been developed and investigated. As reported in 1989, PSA density had shown promising initial results in enhancing PSA's ability to distinguish benign prostatic hyperplasia from PCa. This article reviews the concept and experience with PSA density for the past few years and its possible usefulness in the evaluation of men at risk of harboring PCa.
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