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The prostate-specific antigen test is a blood test that measures levels of a protein the prostate gland produces. Men with prostate cancer usually have elevated levels of this protein, but heightened levels do not always mean cancer.
Other health conditions may also cause prostate-specific antigen (PSA) levels to rise. In some cases, an elevated PSA is temporary and not a sign of a health problem at all.
Cells in the prostate gland produce PSA and levels typically remain below 4 nanograms per milliliter (ng/mL).
Most men with prostate cancer have PSA levels above 4 ng/mL, but about 15 percent of men with a PSA level below 4 ng/mL are also diagnosed with prostate cancer. This means that a PSA test alone cannot rule out or diagnose prostate cancer but can identify whether a man is at higher risk of having or developing the disease.
Initial testing may include both a PSA test and a digital rectal exam (DRE). During this examination, a doctor inserts a finger into the rectum to check the prostate for abnormalities. Together, if these two tests suggest prostate cancer, then the doctor will arrange for a biopsy to confirm the diagnosis.
False positives - a high PSA level, but no cancer - on the PSA test are common. PSA levels rise with age and other factors. Men with high PSA levels should follow up with a doctor, but should not assume they have cancer.
A high PSA level may not always indicate prostate cancer.
Hepatitis C (HCV) is a viral infection that affects the liver and an estimated 3.2 million people in the USA are infected with HCV, and most do not feel ill or know that they are infected. Since 2010, acute cases of HCV have more than doubled, with new cases predominantly among young, white individuals with a history of injection drug use.
The current recommendations are that doctors screen patients at high-risk for contracting HCV, which include but are not limited to people born between 1945 and 1965, those diagnosed with HIV, children born to HCV-positive women and individuals who engage in injection drug use (PWID), among other select populations at high risk. This strategy is called "targeted" screening. "Routine" screening, as defined in the study, tests all individuals in a community with a high prevalence of HCV.
Video: One step Hepatitis C Virus Test Cassette, Raecho International
There are two ways to perform these screenings. Rapid testing is when results are given on the same day that the sample is drawn. Standard testing requires patients to return for a second appointment to get the results. Scientists at Boston Medical Center (Boston, MA, USA) and their colleagues evaluated the clinical benefits and cost-effectiveness of testing strategies among 15 to 30-year-olds at urban community health centers. They developed a decision analytic model to project quality-adjusted life years (QALYs), lifetime costs (2016 USDs) and incremental cost-effectiveness ratios (ICER) associated with nine strategies for one-time testing. The strategies differed in three ways: targeted versus routine testing; rapid finger stick versus standard venipuncture; and ordered by physician versus counselor/tester using standing orders.
Illustration of the Hepatitis C Virus
The team found that compared to targeted risk-based testing (current standard of care), routine testing increased lifetime medical cost by USD 80 and discounted QALYs by 0.0013 per person. Across all strategies rapid testing provided higher QALYs at a lower cost per QALY gained, and was always preferred. Counselor-initiated routine rapid testing was associated with an ICER of USD 71,000/QALY gained. Results were sensitive to offer and result receipt rates. Counselor-initiated routine rapid testing was cost-effective (ICER greater than USD 100,000/QALY) unless the prevalence of PWID was greater than 0.59%, HCV prevalence among PWID less than 16%, reinfection rate greater than 26 cases per 100 person-years, or reflex confirmatory testing followed all reactive venipuncture diagnostics.
Sabrina A. Assoumou, MD, MPH, an infectious disease physician and lead author of the study, said, “When standard testing was applied, patients were less likely to come back for that second appointment to get their results, which in turn meant more people weren't getting the treatment they so desperately needed. Our results indicate that we must initiate rapid testing strategies so that more people will know their status and get treatment more quickly.” The study was published on September 9, 2017, in the journal Clinical Infectious Diseases.
An experimental test that relies on an old-fashioned screening exam — the pap smear — may someday allow doctors to easily detect birth defects sooner than ever.
On Tuesday, Wayne State University (WSU) researchers revealed the latest encouraging findings on their creation, called “Trophoblast Retrieval and Isolation from the Cervix,” or TRIC for short. Using a pap smear, they scraped trophoblasts — the cells that eventually help form a fetus’ placenta — from pregnant women’s cervixes and genetically sequenced the fetal DNA found inside with next generation technology. They then compared these samples to those obtained from the mother, placenta, and fetus via conventional means.
Not only were the TRIC samples mostly made out of fetal DNA, indicating the low risk of contamination, but they matched up perfectly with the other fetal samples, validating the test’s overall accuracy. Even more importantly, the samples were taken as early as 5 weeks into pregnancy, blowing past the limit of other, invasive screening tests, such as amniocentesis, which can only be given starting at the end of the first trimester, 14 to 16 weeks in.
Researchers have developed a test that may be able to screen for birth defects
as early as five weeks into pregnancy.
A new analysis suggests infrequent screening has resulted in an increase in the number of men diagnosed with the metastatic form of the disease.
For decades, experts have said the diagnostic used to screen patients for prostate cancer is too unreliable to use routinely because it produces high rates of false positives and often results in additional unnecessary and invasive tests, as well as overtreatment. However, a new study suggests efforts to limit the use of the prostate-specific antigen (PSA) test may be partially responsible for a rise in incidences of the most aggressive form of the disease.
Hyperglycemia is a frequent finding that can be related to physiologic stress, illness and medications, including steroids and vasopressors and glycated hemoglobin (HbA1c) correlates with the average blood glucose level over the previous eight to 12 weeks.
Screening of HbA1c levels plays an important role in the diagnosis and management of diabetes mellitus in the outpatient setting but remains underused in the evaluation of hyperglycemia with undiagnosed diabetes in the inpatient setting.
