How to cite: Crawford, ED. “Overview of Liquid Biomarkers in Prostate Cancer.” September 15, 2025. Accessed Feb 2026. https://grandroundsinurology.com/overview-of-liquid-biomarkers-in-prostate-cancer/
Summary
E. David Crawford, MD, Professor of Urology, University of California, San Diego, San Diego, California, and Editor-in-Chief, Grand Rounds in Urology, reviews the role of liquid biomarkers in early detection of prostate cancer. He emphasizes that while PSA screening reduces mortality, the lack of consensus among organizations and frequent changes in recommendations have led to confusion and inconsistent practice.
PSA remains a critical biomarker, but interpretation is complex. Analyses of large cohorts show that PSA <1.5 ng/mL is associated with extremely low risk of prostate cancer diagnosis in the next five years, suggesting longer screening intervals are appropriate. Dr. Crawford highlights 1.5 ng/mL as a practical threshold. He notes that benign prostatic hyperplasia often drives PSA elevation, underscoring the need for adjunctive tests.
Dr. Crawford shares a range of liquid biomarkers under evaluation, including PSA, PCA3, 4Kscore, SelectMDx, and others. These tests aim to refine biopsy decisions, reduce unnecessary procedures, and better identify clinically significant cancers.
He asserts that no single biomarker is a definitive “yes/no” test. Rather, biomarkers should be incorporated into clinical decision-making alongside PSA and risk factors.
The Global Summit on Precision Diagnosis and Treatment of Prostate Cancer is a unique multi-disciplinary forum organized to inform the key health care stakeholders about the emerging advances in clinical case and research and create a consensus-based vision for the future of precision care and educational and research strategy for its realization. The mission of the Summit is to fill the currently existing gap between the key experts of in vivo imaging, the world authorities in the in vitro fluid- and tissue-based molecular diagnostics, including genomics, and thought leaders in the development of novel observation strategies (e.g., active surveillance, or AS) and therapeutic interventions.
ABOUT THE AUTHOR
Researcher-physician E. David Crawford, MD, Jack A. Vickers Director of Prostate Research and Professor of Urology at the University of California, San Diego, has devoted his career in medicine to educating the public about men's health issues and finding effective techniques and procedures to address prostate cancer, the most common malignancy affecting men in the United States.
