In diagnosing prostate cancer, what test would follow an elevated PSA level for confirmation?

In the diagnosis of prostate cancer, if a patient has an elevated prostate-specific antigen (PSA) level, the definitive step to confirm the diagnosis is a biopsy. A biopsy involves taking a tissue sample from the prostate gland to examine it for cancerous cells. This procedure is crucial because while an elevated PSA level may indicate the presence of prostate cancer, it can also result from other conditions such as benign prostatic hyperplasia or prostatitis. Therefore, a biopsy is the gold standard that allows for histological examination to confirm the presence of cancer and to determine its aggressiveness.

The other tests mentioned have their roles in the broader context of prostate disease management. A CT scan and a bone scan can be used to determine the extent of cancer if it has already been diagnosed, but they are not used for initial confirmation. A transrectal ultrasound can assist in guiding a biopsy but does not itself confirm cancer. Thus, the biopsy is the most definitive and appropriate follow-up test after an elevated PSA level.