UroToday - Dr. Mark Litwin, UCLA moderated a session on "Exclusion of Inflammation in the Differential Diagnosis of an Elevated PSA: Considerations and Evidence" at the annual SUO meeting at the AUA. Dr. William Catalona, Northwestern University presented the lecture, which was followed by discussion.

Dr. Catalona stated that the median PSA of men without CaP should be 0.7ng/ml in men in their 40's, and increasing slightly as men get older. Overall, it is below1.7ng/ml for most men. For age 50-59, a PSA increasing above 0.9ng/ml is associated with significantly increasing risk. The natural variability of PSA is multifactorial and he focused on inflammation. The coefficient of variation of PSA is 15% when evaluated two weeks apart. Among 972 men who would have had a biopsy based upon initial PSA, 40-50% had a PSA fall below the biopsy level over time suggesting that a second PSA should be performed prior to biopsy. PSA velocity will be recommended as 0.35ng/ml/year based upon newer data.

PSAV is associated with increased detection of CaP but also associated with inflammation. He cited a study by Dr. Schaeffer in which in 42%f men treated with antibiotics, the PSA decreased to

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