About 70 percent of men with rising prostate-specific antigen levels but normal biopsies were eventually diagnosed with prostate cancer, U.S. researchers say.
"Our findings show an elevated and rising PSA level or velocity should lead a clinician to follow a patient more closely, even if he has a negative biopsy," lead investigator Dr. William Catalona, director of the clinical prostate cancer program at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University in Chicago, says in a statement. "One negative biopsy isn't the end of the road."
Elevated PSA levels can indicate prostate cancer but can also be caused by prostate inflammation or prostate enlargement, Catalona says.
The researchers looked in their database at the history of 97 patients with a rising PSA trend who had a subsequent negative biopsy, and found 66 percent were eventually diagnosed with prostate cancer, 20 percent had a benign prostate, 8 percent had protatitis and 6 percent had premalignant lesions.
"This underscores the importance of using a patient's individual PSA trend when deciding whether to pursue a prostate biopsy," co-investigator Dr. Gregory Auffenberg says. "It's not enough to only look at an individual PSA value when historical data is also available."
The findings were presented at the American Urological Association annual meeting.