The evolving biology and treatment of prostate cancer
J. Clin. Invest. Russel S. Taichman, et al. 117:2351 doi:10.1172/JCI31791 [Go to this article.]

Figure 1
Evolving screening guidelines for prostate cancer detection: NCCN early detection screening guideline. Physicians should initiate a discussion of the risks and benefits of early prostate cancer detection and offer baseline screening with DRE and PSA beginning at age 40. PSA values are shown in ng/ml. Men with PSA less than 0.6 ng/ml at age 40 should repeat screening at age 45; if PSA is less than 0.6 ng/ml at age 45, annual screening should be considered at age 50. If initial PSA at age 40 is 0.6 ng/ml or more, or if the patient has a family history of prostate cancer (+FH) or is African American, annual screening with DRE and PSA is recommended. If subsequent PSA is less than 0.6 ng/ml, the patient can repeat screening at age 45; all others should continue with annual screening. In the annual screening group, men with PSA 2.6–4.0 ng/ml, or whose PSA velocity (PSAV) exceeds 0.35 ng/ml/yr, should be considered for biopsy. Biopsy is highly recommended for any individual with PSA greater than 4.0 ng/ml and for men with positive DRE at any point in the screening process. Note that PSA velocity measurements (shown in ng/ml/yr) should be made on at least 3 consecutive specimens drawn over a period of at least 18–24 months.