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Clinicians who order prostate-specific antigen (PSA) tests know that PSA levels can fluctuate randomly from year to year. Researchers in San Antonio assessed the extent of this fluctuation in a prospective cohort study of prostate cancer screening. Nearly 2600 men had undergone two or more consecutive annual PSA tests and digital rectal examinations; 55% of the men had undergone four or more annual PSA tests.
Among men who did not undergo biopsies during the study, 744 had PSA levels ≥2.5 ng/mL and at least one annual follow-up test. At the next test, PSA levels were <2.5 ng/mL in 23%; at the next two tests, PSA levels were lower than this threshold in 20%; and levels on the next three tests were lower than this threshold in 18% of these men…