Earlier PSA tests may be needed

Watching changes in men’s PSA blood tests may be the best way of predicting which men have life-threatening prostate cancer.

A study published in the Nov. 1 issue of the Journal of the National Cancer Institute, strengthens the argument that men should have their prostate specific antigen, or PSA, levels tested when they are young, so doctors have a “baseline” for studying future changes.

“We have found that the rate at which a man’s PSA rises may be more important than any absolute level for identifying men who will develop life-threatening cancer while their disease is still curable,” said Dr. H. Ballentine Carter of the Johns Hopkins School of Medicine in Baltimore.

He and colleagues found that a patient’s PSA velocity 10 to 15 years before his cancer diagnosis was associated with survival 25 years later. Patients with a lower PSA velocity had a 92% survival rate, while patients with a higher PSA velocity had a 54% survival rate.

Carter said the findings suggest that men should consider getting a baseline PSA test around age 40, instead of the more usual 50, to use as a comparison for future changes.