Prostate-specific antigen (PSA) and PSA velocity for prostate cancer detection in men aged <50 years.

Journal Article

OBJECTIVE: To identify threshold values of prostate-specific antigen (PSA) levels and PSA velocity (PSAV) to optimize the assessment of the risk of prostate cancer in young men, as prostate cancer is detected increasingly in men aged <50 years. PATIENTS AND METHODS: Data for a group of 12 078 men, including 1622 with prostate cancer, were retrieved from the Duke Prostate Center Database. Based on the latest date for a PSA assay, these men were divided into two age groups of <50 and >/= 50 years, with 904 and 11 174 men in each group, respectively. Receiver operating characteristic curves (ROC) of PSA and PSAV were calculated and the cancer risk was assessed. RESULTS: The prevalence of prostate cancer was 4.4% (40 men) for men aged <50 years and 14.2% (1582 men) for men aged >/= 50 years. For the group with cancer the median PSA in men aged <50 years was significantly lower than that in men aged >/= 50 (1.3 vs 6.3 ng/mL, P < 0.001). ROC curves of PSA and PSAV showed a breakpoint at a PSA level of 2.3 ng/mL and a PSAV of 0.60 ng/mL/year for men aged <50 years. Both the sensitivity and specificity in the younger group at a PSA level of 2.5 ng/mL were higher than in the older group. CONCLUSIONS: In men aged <50 years the operating characteristics of PSA are more sensitive and specific than in older men. Diagnostic PSA levels in men aged <50 years are significantly lower than suggested by guidelines. Using a 2.0-2.5 ng/mL PSA level threshold for biopsy in men aged <50 years and a PSAV threshold lower than the traditional 0.75 ng/mL/year is reasonable in contemporary practice. Further studies are warranted to validate these thresholds.

Full Text

Duke Authors

Cited Authors

  • Sun, L; Moul, JW; Hotaling, JM; Rampersaud, E; Dahm, P; Robertson, C; Fitzsimons, N; Albala, D; Polascik, TJ

Published Date

  • April 2007

Published In

Volume / Issue

  • 99 / 4

Start / End Page

  • 753 - 757

PubMed ID

  • 17244286

International Standard Serial Number (ISSN)

  • 1464-4096

Digital Object Identifier (DOI)

  • 10.1111/j.1464-410X.2006.06682.x

Language

  • eng

Conference Location

  • England