Approximately 20% of men undergoing prostate biopsy for a screening PSA between 2.6ng/ml and 4.0ng/ml are found to have prostate cancer (CaP). In 1995 Dr Catalona and coworkers changed their screening PSA cutpoint from 4.0ng/ml to 2.6ng/ml. They analyzed the differences in clinical and pathologic stage and progression-free survival (PFS) in the higher (4.0ng/ml, group 1) and lower (2.6ng/ml, group 2) cohorts of these men. The report by Dr. Jang and associates appears in the February 2006 issue of Urology.

Men prior to 1995 had a 4-sector prostate biopsy for a PSA >4.0ng/ml. After 1995 men with a PSA >2.6ng/ml had a 6-sector prostate biopsy. In group 1, 1,141 men who underwent RP were compared to 1,100 men in group 2 who had RP. PSA was serially followed and recurrence defined as a PSA post surgery >0.2ng/ml.

The percentage of patients with stage T1c CaP increased from 45% in group 1, to 80% in group 2. The proportion of men with Gleason score

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