Using PSA to eliminate the staging radionuclide bone scan. Significant economic implications.

The findings of these two large-scale clinical studies indicate that serum PSA is an accurate and reliable predictor of the bone scan findings for 40% of the patients presenting with newly diagnosed, untreated prostate cancer. For these patients with no skeletal symptoms and a serum PSA value of 10 ng/mL or less by either the Tandem-R or the IMx assay, a staging radionuclide bone scan is not necessary, as it provides no additional useful information over what is learned from the serum PSA value. If these bone scans were eliminated for these selected patients, approximately $38 million could be saved annually in the United States. As the incidence of newly diagnosed prostate cancer continues to increase, so will the economic savings associated with using the serum PSA concentration to predict the bone scan findings in appropriate patients.