Do we need PSA and early detection of prostate cancer?

The limitations of PSA as a screening marker for diagnosis and prostate cancer treatment are well known. The low specificity of PSA results in many unnecessary prostate biopsies, furthermore high rates of over-detection and overtreatment affect patients' quality of life. New assays measuring different molecular forms of PSA have resulted only in a moderate improvement of specificity especially beyond the PSA range of 2 to 10 ng/ml. Novel biomarkers for prostate cancer detection are emerging and they might enable clinicians to differentiate indolent from aggressive cancers in order to minimize overtreatment in future. (c) 2008 European Association of Urology. Published by Elsevier B.V. All rights reserved.