Prostate Specific Antigen Screening is a clinical laboratory procedure that measures the concentration of Prostate Specific Antigen (PSA), a protein produced by both normal and malignant prostate cells, in a male’s blood serum. This test is a primary tool used to screen for and monitor prostate cancer, as elevated or rapidly rising PSA levels can indicate prostate disease, though not exclusively malignancy. The screening provides a quantifiable biomarker for assessing prostate health status.
Origin
The PSA protein was originally identified in the 1970s by researchers looking for a forensic marker for semen, leading to its initial use as a marker in sexual assault cases. Its application in prostate cancer screening began in the mid-1980s, fundamentally changing the landscape of prostate cancer diagnosis and management. The term ‘screening’ denotes its use in asymptomatic men to detect potential disease early, prompting a critical and ongoing clinical debate regarding its optimal use and interpretation.
Mechanism
PSA is a serine protease enzyme secreted by the epithelial cells of the prostate gland, with its primary physiological function being the liquefaction of seminal fluid. In prostate disease, whether benign prostatic hyperplasia or cancer, the integrity of the prostate’s structure is compromised, allowing more PSA to leak from the glandular tissue into the bloodstream. The test’s mechanism is a simple immunoassay that quantifies this circulating level, but its clinical interpretation is complicated by the fact that non-malignant conditions, such as infection or inflammation, can also cause a temporary elevation.
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