Prostate cancer is the second most frequent cancer and the fifth leading cause of cancer death among men in 2020. For a disease as common as prostate cancer, relatively little is known about its etiology. Established risk factors are limited to advancing age, family history of this malignancy, and certain genetic mutations (eg, BRCA1 and BRCA2) and conditions (Lynch syndrome). [1] prostate-specific antigen (PSA) is the most widely used tumor maker in prostate cancer. Multi-center study found that the percentage of fPSA and PSA help to detect early prostate cancer.
Clinical Significance
PSA is the most important marker of prostate cancer and is widely used in early detection, aiding diagnosis and recurrence monitoring. Men with a PSA >1 ng/ml at age 40 yr and >2 ng/ml at age 60 yr are at increased risk of PCa metastasis or death several decades later. It is recommended that PSA testing can be taken into account in every 2 years for men at increased risk[2,3].
When PSA is between 4-10ng/ml, the fPSA level is negatively correlated with the incidence of prostate cancer. If fPSA/tPSA,0.25, the probability of prostate cancer is only 8%.