[Additional aids in detection of prostate carcinomas? PSA-prostatic volume quotient, PSA-doubling time, age-dependent PSA reference values and PSA in urine].

Different concepts to improve the clinical utility of prostatic-specific antigen (PSA) for prostate cancer detection have been developed. PSA density and transition zone PSA density are not useful screening tools due to a high variability of prostate volume measurement. PSA velocity monitors the change in PSA in a 2-year period, therefore it is not suitable for treatment decisions in men with serum PSA levels between 4 and 10 ng/ml. Measurement of urinary PSA is not helpful for prostate cancer detection. Age-specific PSA reference ranges provide greater sensitivity for cancer detection in younger men at the expense of a greater negative biopsy rate. In older men unnecessary biopsies could be spared. However, this might lead to a lower sensitivity in these patients, missing possibly clinically insignificant tumors.