Labcorp View on Prostate Cancer Diagnosis

Overview
Prostate cancer accounts for approximately one-fourth of newly diagnosed cancers and almost
10% of cancer-related deaths in men in the United States.1 Traditional screening for prostate
cancer using the prostate-specific antigen (PSA) test has not only increased the number of
cases identified annually but has also increased the proportion of patients who present with
early-stage disease. While PSA is a commonly used screening marker, the diagnosis of prostate
cancer also depends upon the findings from prostate tissue biopsies. Biopsy findings, including
tumor grade and the extent of the cancer (Gleason score), help determine patient prognosis and
influence treatment decisions. Although PSA testing has been helpful in identifying prostate
cancer, there is an ongoing concern called the “prostate dilemma,” because a growing number
of patients present with elevated PSA but with no evidence of disease on biopsy. This issue has
prompted even greater focus on new guidelines, testing, and treatment for prostate cancer.
In March 2009, The American Urological Association (AUA) issued an updated prostate-specific
antigen statement. AUA sites 2 key differences from the policy it issued in 20002:
1. The age for obtaining a baseline PSA has been lowered to 40 years.
2. The current policy no longer recommends a single, threshold value of PSA that should prompt
prostate biopsy. Rather, the decision to proceed to prostate biopsy should be based primarily
on PSA and digital rectal exam (DRE) results but should take into account multiple factors,
including free and total PSA, patient age, PSA velocity, PSA density, family history, ethnicity,
prior biopsy history, and co-morbidities.
These revised guidelines will assist physicians in managing a potential prostate cancer diagnosis.
In addition, Laboratory Corporation of America® Holdings (LabCorp) offers an array of tests to
assist physicians with the diagnosis, prognosis, and management of prostate cancer. These tests
include CaPDETECT: PCA3™, GST-P1, and circulating tumor cells