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Improvement of prostate cancer screening by determination of the ratio free/total PSA in addition to PSA levels

The measurement of prostate specific antigen (PSA) is widely used in screening programs for early detection of prostate cancer. However the specificity for cancer detection is limited because serum PSA is also elevated in patients with benign prostatic‐hyperplasia (BPH) and/or prostatitis. It has been shown recently, that the ratio of free/total PSA in serum is lower in malignant prostatic disorders than in non‐malignant ones and therefore might be a parameter to improve screening specificity. In a retrospective study, we tested whether free/total PSA helps to distinguish between BPH and prostatic carcinoma in men with elevated serum PSA.