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PSA Velocity and Life-Threatening Prostate Cancer

Prostate-specific antigen (PSA) levels are currently used to screen men for prostate cancer, but a substantial number of men are overdiagnosed—they are treated for cancers that would not have become life-threatening. To determine whether the rate at which PSA levels change over time, or PSA velocity, is useful for screening men for life-threatening prostate cancer, Carter et al. (p. 1521 ) calculated the PSA velocities of 980 men enrolled in the Baltimore Longitudinal Study of Aging. The authors found that men with a high PSA velocity 10–15 years before their prostate cancer diagnosis had a greater risk of death from prostate cancer 25 years later than men with a low PSA velocity during that period (1,240 vs. 140 per 100,000 person-years). The authors conclude that it may be possible to identify men with life-threatening prostate cancer at a time when it is possible to prevent death from the disease.