The correlation between prostate-specific antigen level and presence of prostate cancer has steadily declined since the1980s, suggesting that level alone may not be sufficient to decide whether biopsy is necessary, according to study results released at the annual meeting of the American Urological Association. The researchers concluded that level has only been related to benign prostatic hypertrophy since roughly 1998.

In the current research, American investigators examined 1,317 consecutive untreated radical prostatectomies at a single university center performed since August 1983 to explore the relationship of serum level to the largest cancer in 4 different 5-year intervals. Prostates were examined sequentially in 3 mm step-sections by one pathologist, measuring the volume of the largest cancer and the percent Gleason grade 4 or 5, as well as less important histologic parameters.

“The American Urological Association feels that prostate-specific antigen ? in combination with digital rectal exam and a full review of the patient’s history ? is the best way to indicate when a prostate biopsy might be necessary,” said President Martin I. Resnick, M.D. “However, we recognize that the test is not foolproof, and that we need more research to improve its specificity and sensitivity.”