This statement is false. While a Prostate-Specific Antigen (PSA) level below 4.0 ng/mL was historically considered the upper limit of normal, it is not a definitive cutoff to rule out cancer. A significant proportion of men with prostate cancer (approximately 15-25%) have PSA levels within the so-called 'normal' range (<4.0 ng/mL). This is often referred to as 'PSA-negative' cancer. Conversely, many men with PSA levels above 4.0 ng/mL do not have cancer but have benign conditions like BPH or prostatitis. Therefore, PSA is a continuous risk factor, not a binary test. Other factors like PSA velocity (rate of rise), PSA density (PSA relative to prostate size), and free vs. total PSA ratio are used to refine risk assessment. A digital rectal exam is also crucial, as some aggressive cancers may not produce much PSA. Ultimately, the decision for biopsy is based on a combination of PSA, DRE findings, and patient risk factors, not on a single PSA cutoff.

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Zambia

• ivwananji siwale – 29 pts

• Visual Pathway Lesions
• Positive and Negative Symptoms
• Hallucinations and Delusions
• Antipsychotic Medications
• Emergency: Environmental Emergencies