Prostate-specific antigen (PSA) is the most accurate and preferred ser
um marker for the early detection and monitoring of prostate cancer (P
Ca). Although excellent, PSA is not the perfect tumor marker because o
f its limitations in sensitivity and specificity, especially for high
normal or mildly elevated levels. In an effort to improve the clinical
utility of the PSA test, new concepts have been developed and investi
gated. As reported in 1989, PSA density had shown promising initial re
sults in enhancing PSA's ability to distinguish benign prostatic hyper
plasia from PCa. This article reviews the concept and experience with
PSA density for the past few years and its possible usefulness in the
evaluation of men at risk of harboring PCa.