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Use of early PSA velocity to predict eventual abnormal PSA values in men at risk for prostate cancer

Prostate Cancer and Prostatic Diseases volume 6, pages 39–44 (2003)Cite this article

Abstract

The purpose of this study was to determine if early PSA velocity (EPSAV), drawn from PSA values within normal ranges, predicts the later occurrence of abnormally high PSA values or positive prostate biopsy early enough to be clinically beneficial.

Early PSAV (ng/ml/y) calculated from two normal PSA readings was tested to predict later PSA exceeding 4 ng/ml (1551 evaluable patients) or 10 ng/ml (1905 evaluable patients) and positive prostate biopsy. The time from EPSAV to develop abnormal PSA was recorded.

A post-EPSAV PSA>4 ng/ml was reached by 367 patients and >10 by 293. EPSAV was significantly different (P<0.001) between patients whose PSA did or did not reach the PSA cut-off point and also significantly predicted a positive biopsy result (P<0.001). EPSAV predicted abnormal PSA more than 1 y in advance in 68 and 52% of the PSA 4 and 10 ng/ml cut-off point groups, respectively.

Early PSAV from normal PSA readings may allow early detection of men at risk for prostate cancer. This may help identify men for earlier prostate biopsy or for less frequent PSA monitoring.

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Authors and Affiliations

  1. Department of Clinical Investigation, Naval Medical Center, San Diego, California, USA

    R H Riffenburgh

  2. Department of Urology, Naval Medical Center, San Diego, California, USA

    C L Amling

Authors
  1. R H Riffenburgh
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  2. C L Amling
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Correspondence to R H Riffenburgh.

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The opinions and assertions contained herein are the views of the authors and are not to be construed as reflecting the views of the US Navy or Department of Defense.

Appendix

Appendix

We wish to show the relationship between early PSA velocity (EPSAV) and PSA Doubling Time (DblT). Let us take the equation of a straight line as y=a+bx, where x is a position on the horizontal axis representing years, and y is a position on the vertical axis representing PSA values read at the respective x times. Let the first two PSA readings and their respective times be the (x, y) points (t1, p1) and (t2, p2). The slope of the line, b, is EPSAV=(p2−p1)/(t2−t1). Let us denote EPSAV as e to prevent ponderous formulae. Substituting the first point and e leads to the equation for the line through the two points, y=(p1−et1)+ex. We can denote the point at which PSA doubling occurs, that is, where y becomes 2p1, as (t3, 2p1). Substituting this point in the equation and solving for t3 yields t3=p1/e+t1. The time for PSA to double is t3−t1, so that DblT=p1/e, the initial PSA reading times the reciprocal of EPSAV.

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Riffenburgh, R., Amling, C. Use of early PSA velocity to predict eventual abnormal PSA values in men at risk for prostate cancer. Prostate Cancer Prostatic Dis 6, 39–44 (2003). https://doi.org/10.1038/sj.pcan.4500614

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  • DOI: https://doi.org/10.1038/sj.pcan.4500614

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