Neither of the screening tests for prostate cancer is perfect. Most men with an elevated PSA level do not have prostate cancer (false positives), and some men with prostate cancer have a low PSA level (false negatives). The DRE is also associated with false positives and false negatives. Using the DRE and PSA together will miss fewer cancers (greater sensitivity) but also increases the number of false positives and subsequent biopsies in men without cancer (lower specificity).
The National Cancer Institute's (NCI) Early Detection Research Network (EDRN) has a Prostate Collaborative Group that is exploring a variety of strategies to find better ways to detect prostate cancer early. In addition, NCI's prostate cancer Specialized Program of Research Excellence (SPORE) is funding projects to identify new diagnostic and prognostic biological markers, or biomarkers, of prostate cancer besides PSA.
This answer is based on source information from the U.S National Institutes of Health.
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