From bench to bedside: the evolution and future of prostate-specific antigen testing.

Abstract

Prostate cancer is the most common cancer in males in the U.S. except skin cancer. Prostate-Specific Antigen (PSA) is a glycoprotein enzyme produced by the prostate epithelial cells that has become a pivotal biomarker in the diagnosis, monitoring, and management of prostate cancer. Since its identification in seminal plasma in the early 1970s and subsequent purification from prostate, PSA has been widely adopted in clinical practice for screening for prostate cancer, particularly after FDA approval for this purpose in 1994. This study reviewed the historical development of PSA, its biochemical and physiological properties, and its clinical applications in cancer detection, staging, and monitoring. The advantages of PSA testing, including its role in early detection and reduction of prostate cancer mortality, are balanced against limitations such as false positives, overdiagnosis, and overtreatment. Recent innovations, including PSA derivatives, imaging techniques, urinary biomarkers, and risk calculators, are also discussed as tools to improve accuracy in diagnoses. As research progresses, PSA remains a valuable, though imperfect, component of prostate cancer care, with ongoing efforts aimed at enhancing its specificity and integrating it into personalized screening strategies. Such a study would be more helpful for clinicians to effectively use PSA as a screening biomarker and/or monitoring biomarker for prostate cancer.