Men who are clinically determined with prostate cancer seem to have aggressive therapy, even if they have a low prostate-specific antigen (PSA) level and low-risk disease, based on a report in the July 26 concern of Archives of Internal Medicine.

More than 90% of all prostate cancers are clinically determined before the disease has extended to other parts of the body, and the five-year survival rate for these patients clinically diagnosed with localized disease is nearly 100%, based on background information in the article. The five-year survival rate from all phases of disease rose from 69% in 1975 to nearly 99% in 2003.

To ascertain existing risk profiles and treatment patterns of men with prostate cancer and PSA levels below this tolerance, Yu-Hsuan Shao, Ph.D., of the Cancer Institute of New Jersey, New Brunswick, and colleagues used data from the Surveillance, Epidemiology and End Results system. Of 123,934 men with recently clinically diagnosed prostate cancer from 2004 to 2006, 14% had PSA levels of 4 nanograms per milliliter or lower.

The authors advise that if the tolerance PSA value for biopsy were dropped from 4.0 to 2.5 nanograms per milliliter, the number of men with abnormal PSA levels would double to around 6 million.