PROSTATE-SPECIFIC ANTIGEN - CRITICAL ISSUES

Objective. To assess recent developments in prostate-specific antigen (PSA) methods, the recent literature concerning PSA has been reviewed. Salient developments related to new advances in the application of this most important tumor marker are discussed. Results. PSA has clearly revolutionized how we approach men with prostatic disease. Its applicability continues to evolve. Undoubtedly, the largest use is in the areas of early detection, screening, and as ail adjunct to diagnosis. In this regard, considerable attention has been placed on increasing the specificity of this analyte. Such concepts as PSA density, PSA velocity, and age-specific PSA are gaining increased interest and have engendered some controversies. The use of PSA in staging has been increasingly refined, as has its most established utility, that of monitoring patients with established malignancy. Conclusions. Despite its entrenchment in the management of patients, we continue to evolve in our understanding of PSA and strive to improve its performance characteristics. The future undoubtedly will bring many new developments in the area of prostate tumor markers.