Assays for prostate cancer : changing the screening paradigm?

Mol Diagn Ther. 2013 Feb;17(1):1-8. doi: 10.1007/s40291-013-0014-y.

Abstract

Prostate cancer (PCa) screening and detection have changed dramatically since the introduction of serum prostate-specific antigen (PSA) testing. Despite the resulting improvement in early PCa detection and stage migration, in clinical practice the use of PSA testing may cause overdetection and ultimately overtreatment. As a consequence, novel biomarkers are needed to increase the specificity of PCa detection. The aim of this article is to present an overview of novel blood- and urine-based biomarkers that may optimize PCa detection, with improved identification of patients with significant PCa and avoidance of unnecessary prostate biopsies. A systematic and comprehensive PubMed search was performed using the MeSH search terms 'prostate cancer', 'biomarker', 'marker', and 'detection'. Results were restricted to the English language. Several blood- and urine-based biomarkers have the potential to improve prediction of the presence and/or significance of PCa. Ideally, biomarkers should be used in combination within multivariate models, leading to superior accuracy for prediction of any PCa or clinically significant PCa, compared with the use of a single marker.

MeSH terms

  • Annexin A3 / urine
  • Antigens, Neoplasm / urine
  • Biomarkers, Tumor / blood
  • Biomarkers, Tumor / urine
  • Biopsy / methods
  • DNA / urine
  • Early Detection of Cancer / methods*
  • Humans
  • Male
  • Plasminogen Activators / blood
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / diagnosis*
  • Sensitivity and Specificity
  • Serine Endopeptidases / urine

Substances

  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • prostate cancer antigen 3, human
  • DNA
  • Annexin A3
  • Plasminogen Activators
  • Serine Endopeptidases
  • TMPRSS2 protein, human
  • Prostate-Specific Antigen