Evaluation of Percentage of Free Serum Prostate-Specific Antigen to Improve Specificity of Prostate Cancer Screening

Influence of metformin use on PSA values, free-to-total PSA, prostate cancer incidence and grade and overall survival in a prospective screening trial (ERSPC Aarau)

“…Lower ratios have been shown to indicate risk of PCa among men with elevated serum PSA [23] as well as below 3 ng/ml [24]. If lower ratios indicate increased risk of PCa, one should assume that higher ratios are associated with reduced risk of PCa, which is not supported by our data.…”

The use of prostate specific antigen (PSA) density in detecting prostate cancer in Chinese men with PSA levels of 4–10 ng/mL

“…A level of total PSA of 4.0 ng/mL has traditionally been used as the threshold for consideration of a prostate biopsy, recognizing that 30-35% of men in the intermediate PSA range (4-10 ng/mL) will be found to have cancer (Oncology et al 2007). There have been several reports on clinical variables, which may improve the speciWcity in the early detection of CaP, including PSA density (Benson et al 1992), PSA density of the transition zone (Zlotta et al 1997), age-speciWc reference ranges (Oesterling et al 1993), PSA molecular forms (Catalona et al 1995;Okihara et al 2002), PSA velocity (Carter et al 1992), PSA doubling time (Schmid et al 1993) as well as transrectal biopsy techniques (Eskew et al 1997;Babaian et al 2000).…”

Limited usefulness of the free-to-total prostate-specific antigen ratio for the diagnosis and staging of prostate cancer in Japanese men

“…11 These findings suggest that the f/t PSA ratio may be more closely associated with the progression of prostate cancer than tPSA, and, accordingly, this ratio could be more useful for the staging and diagnosis of prostate cancer. However, it seems controversial whether the f/t PSA ratio is able to accurately detect prostate cancer and to predict histopathological findings, [6][7][8][9][10] and few studies concerning the significance of the f/t PSA ratio in Japanese men have been published.…”