Using prostate-specific antigen to eliminate unnecessary diagnostic tests: significant worldwide economic implications.
As the 21st century approaches, it is necessary for urologists worldwide to diagnose and stage malignancies in a cost-effective manner. With the recent advances in the use of prostate-specific antigen (PSA), it is now possible to avoid many time-consuming, expensive, and invasive procedures that have been commonplace in the past. PSA has replaced transrectal ultrasonography (TRUS) as a first-line diagnostic test for evaluating men for early, curable prostate cancer. In older men, the use of age-specific reference ranges for serum PSA can significantly decrease the number of prostate biopsies that are routinely performed. With regard to staging procedures, PSA can now be used successfully to eliminate the bilateral pelvic lymphadenectomy in 30% of men with clinically localized disease and the radionuclide bone scan in 40% of patients with newly diagnosed prostate cancer. In the discussion that follows, the use of serum PSA in the diagnosis and staging of prostate cancer will be discussed. In addition, the economic benefit achieved through proper use of this tumor marker will be reviewed.
Oesterling
J E
JE
Michigan Prostate Institute, University of Michigan, Ann Arbor 48109, USA.
D001706:Biopsy / Q000191:economics; D001842:Bone and Bones / Q000000981:diagnostic imaging; D003363:Cost Control; D003955:Diagnostic Tests, Routine / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000191:economics; D008297:Male; D010818:Practice Patterns, Physicians' / Q000191:economics*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000191:economics*; D011877:Radionuclide Imaging / Q000191:economics; D012680:Sensitivity and Specificity
D017430:Prostate-Specific Antigen