title: [Role of PSA velocity in the detection of prostate cancer. A study of 986 males].
abstract: OBJECTIVE
  To analyze the role of PSA velocity (PSAV) in the detection of prostate cancer (Pca) when compared to other valid alternatives.
  
  
  METHODS
  From a Pca screening program, 986 men were evaluated in two visits (601 of them agreed for a third visit). Serum PSA was performed in every visit (PSA1, PSA2 and PSA3). All Pca diagnosed after PSA1 were excluded. Criteria for biopsy (PSA2 and PSA3) were PSA > 4 ng/ml, or PSAV > 0.7 ng/ml/year. Diagnostic performance of PSAV was compared with other options (PSA alone, DRE, and PSA density -PSAD-).
  
  
  RESULTS
  Median age was 57 years. Median interval between visits were 679 days and 852.5 days respectively. During PSA2, 122 biopsies were indicated (91 performed). After PSA3, 78 were indicated and 24 done. This great proportion of not biopsied men was due to refusal. Seven Pca were detected during PSA2, and 5 during PSA3. Sensitivity of PSAV (two draws) was 0.86, specificity 0.95, missed 1 cancer of 7 and needed 7.5 biopsies per cancer. When three PSA samples available, PSAV missed 2 cancers of 5, and 2.7 biopsies per cancer needed. PSA alone detected 86% of the cancers, multiplying by 2 the number of biopsies needed. Not DRE, nor PSAD improved the diagnostic performance of PSAV when combined with this parameter.
  
  
  CONCLUSIONS
  Diagnostic performance of PSAV was found to be unacceptable in our hands. The need for a third biopsy in these studies make them difficult to reproduce. Validation of PSAV is a difficult task to achieve, we think its role remains questioned.
authors.affiliation: Servicio de Urología, Hospital Universitario de Getafe, Madrid.
authors.forename: M
authors.initials: M
authors.lastname: Luján Galán
authors.forename: A
authors.initials: A
authors.lastname: Páez Borda
authors.forename: I
authors.initials: I
authors.lastname: Romero Cajigal
authors.forename: J M
authors.initials: JM
authors.lastname: Gómez de Vicente
authors.forename: E
authors.initials: E
authors.lastname: Martín Osés
authors.forename: A
authors.initials: A
authors.lastname: Berenguer Sánchez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood*
chemical_list: D017430:Prostate-Specific Antigen