Ideally a screening test should detect all clinically significant prostate cancers and not benign pathologies. It has been normal practice that men who are found to have an abnormal serum PSA level should have a prostate biopsy. For example, the UK Prostate Cancer Risk Management Programme (PCRMP) states “if your PSA is definitely raised, a prostate biopsy is required to determine whether cancer is present” The justification for performing biopsy in men with an abnormal PSA is that they are at high risk of prostate cancer. However, data from the Prostate Cancer Prevention Trial (Thompson, 2006) and Baltimore Longitudinal Study on Aging (Fang, 2001) have demonstrated that.
