Young man's PSA is good cancer predictor

Research from the US suggest that maybe young men should be screened for prostate cancer rather than older ones!

Levels of prostate specific antigen (PSA) in young men seem to foretell their likelihood of developing prostate cancer later in life, according to th a new study in the Journal of Urology.

Dr. Alice S. Whittemore, of Stanford University School of Medicine, California, and colleagues assessed PSA levels from blood samples collected from a group of young black and white men between 1959 and 1966. The subjects, who were 34 years old on average at the time the samples were taken, were followed for several decades for prostate cancer.

The prostate cancer risk increased with increasing PSA in black and white men.

'When the men were young, their PSA levels were well within the normal range, but the men with higher (though still normal) levels had higher risk,' Whittemore said in a Reuters interview.

Specifically, for men with the highest levels compared to those with the lowest, the chances of developing prostate cancer were 4.4-times higher for black men and 3.5-times higher for white men.

There are several possible explanations for a positive relationship between PSA in young adulthood and prostate cancer risk later in life.

A direct biological reason could be that PSA in youth may increase in proportion to the number of premalignant or malignant cells in the prostate. Or, 'PSA may itself contribute to neoplastic initiation or progression in the prostate,' the researchers point out. Another possibility is that inflammation of the prostate increases PSA as well as the subsequent risk of prostate cancer.

'One might think that we should screen men at younger ages,' Whittemore noted. However, we still don't know if PSA screening saves lives,' she said.

"The disease is common in older men, yet only a tiny fraction of these cancers would cause trouble had they never been detected," she commented. Also, 'Screening carries a psychological burden, not to mention the cost.'