US experts say that the prostate-specific antigen (PSA) era as we know it is probably over when it comes to the detection of prostate cancer. Stamey and colleagues reviewed 20 years' worth of data (from 1983 to 2003), finding a declining relationship between serum PSA level and the largest prostate cancers, from 44% in 1983–1988 to 2% in 1999–2003. Higher PSA levels reflect an overall greater prostatic volume rather than the presence of prostate cancer per se. Two decades ago, the prostatic tumours diagnosed were generally large, generating PSA levels that were high enough to provide an accurate measure of cancer severity; this is no longer the case today.
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