PSA : role in screening and monitoring patients with prostate cancer

The test used for early detection and monitoring of prostate cancer—prostate-specific antigen (PSA)—is one of the most accurate and frequently used tumor markers in medicine today. No tumor marker has had such a critical impact on early detection through stage-migration, and monitoring after treatment for prostate cancer as the blood test PSA. This chapter provides an overview of the PSA test and its distinct molecular forms in blood, in screening, early detection and monitoring of prostate cancer. This chapter gives a summary of the randomized controlled trials of PSA-screening and recommendations from national guidelines groups. The chapter discusses the role of the PSA-test as a tool to discriminate clinically significant from indolent prostate cancer at prostate biopsy as well as the growing evidence regarding its role as a risk-stratification tool and prognostic marker of future lethal prostate cancer