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C. B. Good, MD, MPH; Jeff Whittle, MD, MPH; David S. Macpherson, MD, MPH; Joseph Conigliaro, MD, MPH; Melissa McNeil, MD, MPH
Pittsburgh, Pa

Arch Intern Med. 1996;156(12):1352-1353.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

We appreciate the comments of Douville and Cembrowski, which touch on some of the controversies of routine PSA testing. We maintain our stance that DRE causes a clinically insignificant increase in the serum PSA level, although in our study, 6 of 202 men had increases in PSA levels from normal to abnormal. It is known that PSA values fluctuate, and the absolute cutoff point of 4 µg/L is somewhat arbitrary; thus, we would not recommend that any patient receive invasive urologic procedures based on a single, borderline test result. Rather, our approach for the minority of patients with equivocal results (be it 3.9 or 4.1 µg/L would be to repeat the test unless a mass or nodule was found on DRE. While a few patients might get additional testing with this approach, we believe that it is less costly and inconvenient than having all patients return for PSA testing at . . . [Full Text PDF of this Article]

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