Prostate-Specific Antigen, Digital Rectal Examination, and Transrectal Ultrasonography: Their Roles in Diagnosing Early Prostate Cancer  MICHAEL R. CUPP, M.D., JOSEPH E. OESTERLING, M.D.  Mayo Clinic Proceedings  Volume 68, Issue 3, Pages 297-306 (March 1993) DOI: 10.1016/S0025-6196(12)60052-4 Copyright © 1993 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 1 Age-specific incidence of prostate cancer and mortality rates (per 100,000) in the United States. Solid circles = incidence rates for prostate cancer; open circles = mortality rates for prostate cancer. Mayo Clinic Proceedings 1993 68, 297-306DOI: (10.1016/S0025-6196(12)60052-4) Copyright © 1993 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 2 Individual serum prostate-specific antigen (PSA) values for men with benign prostatic hyperplasia (BPH) and men with organ-confined prostate cancer. Horizontal lines = mean values. (From Cupp MR, Oesterling JE. DRE, PSA and TRUS: a proposal for their efficient use in early detection of clinically significant prostate cancer. AUA Today 1992; 5:1-9. By permission of the American Urological Association.) Mayo Clinic Proceedings 1993 68, 297-306DOI: (10.1016/S0025-6196(12)60052-4) Copyright © 1993 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 3 Algorithm for use of digital rectal examination (DRE), prostate-specific antigen (PSA) value, and transrectal ultrasonography (TRUS) in early detection of clinically significant prostate cancer. * = Tandem-R PSA assay, ng/ml; ** = PSA density (serum PSA concentration/prostate volume); † = three cores from each side of the prostate (base, middle, and apex); ‡ = single or multiple cores from lesion identified by TRUS. Mayo Clinic Proceedings 1993 68, 297-306DOI: (10.1016/S0025-6196(12)60052-4) Copyright © 1993 Mayo Foundation for Medical Education and Research Terms and Conditions