Prostate Cancer: PSA and Other Diagnostic Modalities for the Early Diagnosis

The incidence of prostate cancer (PCa) in India is shown to have increased with increasing life-expectancy, use of diagnostic marker like prostate specific antigen (PSA) and changing life style. Prostate cancer occurs at an old age with peak incidence occurring after 65 years of age. Since PCa is often asymptomatic, screening for prostate cancer is essential for an early diagnosis in men above 55 years of age. PSA is the most widely used biomarker for the early diagnosis of PCa. However, the use of PSA as a screening tool for the early diagnosis of PCa has been controversial. The use of PSA combined with Digital Rectal Examination (DRE) improves the possibility of diagnosis of PCa. Imaging techniques are much more used for staging of PCa and for guiding of needle biopsy. The present review describes various diagnostic modalitieswith its merits and demerits, whether used for the early diagnosis of PCa in an individual patient by urologist or used for population screening purposes.