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Prostate cancer gene 3 (PCA3) is overexpressed in prostate cancer cells. Its product can be measured in urine specimens collected after digital rectal exams; FDA-approved assays are available for clinical use. To determine how PCA3 might help clinicians decide which patients with elevated prostate-specific antigen (PSA) levels should undergo biopsies, researchers conducted this study of 1913 men with PSA levels ≥2.5 ng/mL. All men underwent PCA3 testing before undergoing biopsies.
Biopsies were positive for cancer in 42% of patients. If only men with PCA3 scores ≥35 had undergone biopsies, about 1300 men would have avoided procedures, but about 400 of the 800 cancers would have been missed. In contrast, if the cutoff for a positive PCA3 scor…