Will determination of prostate specific antigen density improve the diagnosis of prostatic carcinoma

: Prostate specific antigen (PSA) serum levels in patients with prostate carcinoma and with benign prostate hyperplasia overlap. In order to improve the positive predictive value of PSA in the diagnosis of prostate carcinoma the authors recommend to evaluate the PSA levels in relation to the prostate volume, the so-called density of the prostate specific antigen (PSAD). The correlation of PSA and PSAD with results of bioptic examination revealed that PSAD does not increase the capacity of PSA to predict the presence of prostate carcinoma and does not reduce the number of prostate biopsies. All patients with PSA levels higher than 4 ng/ml and/or a pathological finding on digital rectal examination need a bioptic examination of the prostate.