Highlight
This retrospective PLCO trial analysis reveals that approximately 22% of elevated PSA measurements fall below biopsy thresholds on repeat testing the following year, highlighting significant annual intra-individual PSA variability. Over half of men with initial elevated PSA had subsequent lower PSA levels, supporting the utility of guideline-recommended confirmatory PSA testing before proceeding to biopsy. Importantly, a predictive scoring tool indicates that patients with persistently elevated PSA levels above biopsy thresholds have a low probability of reduction, suggesting these patients could safely bypass repeat PSA testing and proceed directly to further diagnostic evaluation.
