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In clinical practice, post-test probabilities are often just estimated or even guessed. This is usually acceptable in the finding of a pathognomonic sign or symptom, in which case it is almost certain that the target condition is present; or in the absence of finding a sine qua non sign or symptom, in which case it is almost certain that the target condition is absent.
PSA levels between 4 and 10 suggest you could have about a 25 percent chance of prostate cancer, and levels over 10 signal that your chance of having the cancer is more than 50 percent.
A small amount is not protein-bound and is called 'free PSA'. In men with prostate cancer, the ratio of free (unbound) PSA to total PSA is decreased. The risk of cancer increases if the free to total ratio is less than 25%. (See graph) The lower the ratio is, the greater the probability of prostate cancer.
While many screening tests (such as the fecal occult blood test or PSA test) are non-invasive, it is important to note that mammography (breast cancer screening) involves ionizing radiation exposure. [10] The breast is highly radiation sensitive, and it receives an approximate dose of 2.6 milligrays per mammography screening. [11]
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The Prostate Health Index (PHI) is a PSA-based blood test for early prostate cancer screening. It may be used to determine when a biopsy is needed. [32] [46] Prostate cancer antigen 3 is a urine test that detects the overexpression of the PCA3 gene, an indicator of prostate cancer. [32] [46] [47] [44]
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