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Prostate-Cancer Risk Stratification via Early PSA Testing.

The American Cancer Society (ACS)1 and the American Urologic Association (AUA)2 both recommend initiation of prostate-specific antigen (PSA) screening in the 40s (the ACS recommends age 45 and the AUA age 40) for African American men and men with a family history of PSA, and age 50 for all other men with at least a 10-year life expectancy. The National Comprehensive Cancer Network (NCCN) recommends obtaining a baseline PSA level for all men in their 40s.3 PSA screening remains controversial, as many critics point out that it has never demonstrated a survival advantage. Many groups, therefore, do not recommend PSA screening at all. A burgeoning body of literature now deals with the long-term predictions that can be made with PSA values obtained from patients while in their 40s.4,5 Two prominent articles on early risk stratification have been published recently.