The discovery of prostate specific antigen as a biomarker for the early detection of adenocarcinoma of the prostate

Purpose: Prostate specific antigen is the most widely used oncological biomarker in medicine today. Before its implementation as an early diagnostic marker, urologists were limited to prostatic acid phosphatase, digital rectal examination and transrectal ultrasound for the detection of prostate cancer. We review the history of the discovery of prostate specific antigen as a biomarker for the early detection of adenocarcinoma of the prostate. Materials and Methods: We performed a structured literature review, searching PubMed for papers on the subject of prostate specific antigen limited to humans between the years 1970 to 2005. We found a total of 8,365 articles. Results: While the use of prostate specific antigen in evaluating newly diagnosed prostate disease, and followup of men after treatment for prostate disease is accepted practice, prostate specific antigen screening for prostate cancer remains controversial. Conclusions: In the next decade the results of randomized trials of screening may answer some of the questions posed at the beginning of the prostate specific antigen era. To what extent does prostate specific antigen screening affect prostate cancer mortality and at what cost?