Is There Still a Role for Prostatic Acid Phosphatase? CSCC Position Statement

Prostatic acid phosphatase (PAP) was the main biochemical diagnostic test for prostate cancer (PC) until the arrival of prostate-specific antigen (PSA). The rapid rise in the use of PSA, and its use in monitoring, diagnosis, and screening of PC (1) raises the question of whether there is any role for PAP in todayʹs laboratory. In some provinces, such as Ontario, this question is important not only clinically, but in terms of licensing: PAP is a licensed (and government funded) test, whereas PSA is not. The following is a brief summary of evidence obtained from a search of the literature over the past 10-15 years. This summary considers the use of these two tests for diagnosis, staging, prognosis, and monitoring the effects of therapy in prostate cancer patients. A recommendation regarding its use is made at the end of the review. A different use of PAP is in screening for the presence of semen in specimens taken from rape victims. Because such specimens are not usually measured by routine clinical laboratories, this liter-ature has not been reviewed.