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Modified PSA testing spots men who will benefit most

A modified method of PSA testing can identify those men with prostate cancer who would benefit most from early treatment, a UK study reports.

Researchers found measuring the percentage of free

and total PSA ­ a technique 'patchily' available to GPs ­ successfully picked out patients with aggressive, high-grade

disease.

The study could help solve GPs' dilemma over whether to test asymptomatic men, by restricting further investigations to those most in need.

In the screening study of 773 men aged 50 to 65, all the men identified with aggressive high-grade prostate cancer had a free/total PSA ratio below 12.5 per cent.

The researchers also found low free/total ratios were associated with a high level of acute inflammation ­ but that a course of antibiotics could exclude those patients.

Study leader Dr Ed Rowe, specialist registrar in the department of urology at St Mary's Hospital in London, said: 'It might actually be superbly accurate at picking up aggressive cancer. If it's shown to be the case that low free/total PSA is associated with more aggressive cancer then screening would be a better option.'

But he added: 'A low ratio was also associated with inflammation.

'If someone has an abnormal test the first thing might be to give a month's course of antibiotics and then repeat the blood test.'

The study was published

online in the British Journal of Cancer.

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