Prostate-Specific Antigen

The primary purpose of any screening exam is to detect the early stages of a pathological condition, enabling timely intervention and preventing unnecessary morbidity or mortality before clinical signs or symptoms develop. In prostate cancer screening, an elevated serum prostate-specific antigen (PSA) level is the most common initial laboratory finding, as the vast majority of men with early prostate cancer are asymptomatic. PSA is a highly sensitive but relatively nonspecific and imprecise screening tool, as both benign and malignant conditions elevate the serum marker. The use of PSA screening has become controversial, with differing guidelines and recommendations regarding its application across various age groups. Despite the risks associated with serum PSA screening, including the potential for unnecessary biopsies and overdiagnosis, it remains the single most useful tool for the early detection of prostate cancer, offering patients the best chance for a cure. Although the use of PSA for prostate cancer screening is somewhat controversial, its effectiveness in determining the extent of malignancy, monitoring disease progression, identifying biochemical recurrences, and evaluating treatment response is unquestionable.