What is the best cutoff value of PSA in detection of prostate cancer

While a PSA threshold of 4ng/ml has traditionally been accepted as the level at which to recommend prostate biopsy, deciding whom to biopsy has become even more complicated with the results of Prostate Cancer Prevention Trial (PCPT). This study showed that prostate cancer exists at all PSA levels instead of a certain cut-off level of PSA. It has always been important for an urologist to decide to get biopsy from a patient regarding the patients PSA level and age, and to avoid over-treatment. In this review, the results of the remarkable studies published up to date have been explained and how our daily clinical practice is shaped according to these studies is described.