<p><strong>For people undergoing prostate cancer screening, clinicians should not use PSA velocity as the sole indication for a secondary biomarker, imaging, or biopsy. (<em>Strong Recommendation; Evidence Level: Grade B</em>)</strong></p>
Discussion
Discussion
<p>With knowledge of a patient’s age, PSA, DRE, percent free PSA, family history of prostate cancer, and presence of a previous biopsy, large-scale studies in Europe and the U.S. have shown the addition of PSA velocity at various thresholds does not add value in predicting the presence of clinically significant prostate cancer.<sup>94, 95</sup> Therefore, PSA velocity should not be used as sole indication for secondary biomarker, imaging, or a biopsy. Paradoxically, very high PSA velocity (> 3 ng/mL/year) is more closely associated with the presence of inflammation on biopsy rather than cancer.<sup>96</sup></p>