High result in prostate specific antigen test

Editor—Mokete et al say in their 10-minute consultation that age specific ranges of prostate specific antigen (PSA) have been adopted to improve prostate cancer detection,¹ but the values they quote (unreferenced) are at odds with those promoted by the NHS cancer screening programme cited in the article's Useful reading section. For example, the NHS guidance implies that a PSA > 5 ng/ml is suspicious in a man who is 70 or older, but the table in this article says that PSA values up to 6.5 ng/ml are normal in this age group.

Much debate continues around the usefulness, or otherwise, of prostate cancer screening, and PSA action limits differ, depending on which set of guidelines are being followed. However, in the United Kingdom the figures from the cancer screening programme are the ones that NHS primary care clinicians are being asked to follow.