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Article
January 25, 1995

New Information About Prostate-Specific Antigen and the Paradoxes of Prostate Cancer

Author Affiliations

From the Department of Urology, University of Washington School of Medicine, Seattle.

JAMA. 1995;273(4):336-337. doi:10.1001/jama.1995.03520280082045
Abstract

The tumor marker prostate-specific antigen (PSA) has changed the way we think about and manage carcinoma of the prostate to a degree unprecedented in human oncology. Elevated serum concentrations can occur in men with benign prostatic hyperplasia but are more frequent and higher in those with cancer. Serum PSA measurements have become indispensable for monitoring disease, but their use for screening is controversial and highlights the paradoxes of this neoplasm.

See also p 289.

What confuses us about prostate cancer is that it usually grows slowly and is predominately a malady of aging. Among men older than 70 years who die of something else, 30% also have "autopsy" cancer of the prostate, usually with cancer volumes less than 0.2 cm3 and low-grade cell types.1 Yet prostate cancer is the second leading cause of male cancer death. Clinical cancer of the prostate can only be cured if localized, and

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