Management of prostate cancer was revolutionized by the discovery of prostate specific antigen. While prostate specific antigen is an excellent biomarker for followup after treatment, it has low specificity as a screening test and most biopsies are negative when prompted by elevated prostate specific antigen. Better prognostic biomarkers are needed to improve risk stratification to decide between treatment and observation.Methods:
We reviewed the current evidence for and against available biomarkers, and discuss the specific contexts in which biomarkers may have greatest usefulness.Results:
Recently introduced biomarkers attempt to improve on all aspects of the current prostate cancer management paradigm, including screening and diagnosis of disease, risk stratification and treatment allocation as well as disease monitoring after treatment.Conclusions:
Each marker represents an important advance in 1 or more disease settings. Further studies are needed to determine the comparative effectiveness and cost-effectiveness of these biomarkers, and identify which tests or combinations are most useful and usable.