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December 2, 1998

Free PSA for Detecting Prostate Cancer

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(21):1825. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-21-jbk1202

To the Editor.—Dr Catalona and his colleagues1 suggest that it is acceptable to forgo further workup for patients with total PSA values of between 4 and 10 ng/mL and a free PSA value of greater than 25% because such patients would have an 8% probability of cancer after a PSA screening (their Table 6). However, the authors do not recommend this approach when the probability of cancer is 16% or 20% after a free PSA screening, even though both have a less than 25% probability of cancer before a free PSA screening. This begs the question of what is the appropriate threshold?

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