I'm 48. In august, 2004 my first psa
test came in at 3.1. I waited several
weeks and had another test in november
2004: 3.1 again. I was referred to a
urologist, who performed a dre which
revealed no abnormalities. He suggested
biopsy. I suggested holding off on it
and checking psa levels over the next few
months. In late march 2005 (at a
different lab) the level was 3.3. They
forgot to do a psaii as the urologist had
requested, and so, within two weeks I had
yest another psa (same lab): 3.8 total,
but a 27% free-to-total ratio.
As you can tell, I do not relish the
thought of undergoing the biopsy. The
free-to-total is encouraging, but I don't
know what to make of the jump in total.
I have read studies, reviews of studies,
and "meta-analyses" on the sensitivity of
the free-to-total test. A growing
consensus suggests that a f-t ratio of 25%
or more yields a cancer probability at
<10%. Further, the false negative
rate on biopsies is said to be around 20%.
I'm half tempted to hone up on on bayesian
probability calculus to figure out what my
odds are! Am I simply being unreasonable
in avoiding the biopsy?
