De que morrem as crianças de 5 a 14 anos no estado do Rio de Janeiro? Análise do período 2000-2019 / What do children aged 5 to 14 years die from in the state of Rio de Janeiro, Brazil? Trend analysis of the period 2000-2019

Resumo Objetivou-se investigar a magnitude e a tendência da mortalidade de crianças de 5 a 14 anos por causas, no estado do Rio de Janeiro, de 2000 a 2019. Estudo ecológico de tendência temporal utilizando dados do Sistema de Informações sobre Mortalidade (SIM). Calcularam-se taxas de mortalidade por 100 mil crianças, por capítulos, grupos e categorias (CID-10). Estimou-se a série temporal por regressão joinpoint. As taxas de mortalidade de 10 a 14 anos foram superiores às da faixa de 5 a 9 anos. As cinco principais causas foram as mesmas de 5 a 14 anos, com diferente ordem de importância. As duas principais foram causas externas e neoplasias (31% e 15% para 5 a 9 anos; 45% e 11% para 10 a 14 anos). De 5 a 9 anos, a tendência da mortalidade teve declínio anual (8%) entre 2011 e 2015. De 10 a 14 anos, o declínio anual foi 1,3%, de 2000 a 2019. A mortalidade por causas externas decresceu em ambas as faixas, menos para a categoria "Agressão por arma de fogo" (meninos,10-14 anos) e "Afogamento" (meninos, 5-9 anos). A mortalidade por neoplasias ficou estável para todos. Doenças infecciosas e respiratórias decresceram de forma diferenciada entre os grupos. A maioria das causas de morte é evitável ou tratável, apontando necessidade de investimentos em saúde e intersetoriais.

Abstract This study investigated the magnitude and trends of cause-specific mortality among children 5 to 14 years of age in the state of Rio de Janeiro (RJ) from 2000 to 2019. We performed an ecological study, using data from the Mortality Information System (MIS). We calculated mortality rates per 100,000 children by chapters, groups, and categories of causes of death (ICD-10). Trends were estimated by joinpoint regression. Mortality rates among children aged 10 to 14 years were higher than those among children 5 to 9. The five leading causes of death were the same in both age groups, but they ranked differently. The two leading ones were external causes and neoplasms (31% and 15% among children aged 5 to 9 years; 45% and 11% among children aged 10 to 14 years). Among children 5 to 9 years, the mortality trend showed an annual decline (8%) from 2011 to 2015. Among children aged 10 to 14 years, the annual decline was 1.3% from 2000 to 2019. Mortality due to external causes decreased in both age groups, except for the category "Assault by unspecified firearm" (boys, 10 to 14 years) and "Unspecified drowning and submersion" (boys, 5 to 9 years). Mortality caused by neoplasms remained steady in both age groups. Infectious and respiratory diseases decreased differently between the two groups. Most causes of death are preventable or treatable, indicating the need for health and intersectoral investments.

Population-based study: breast cancer mortality trend in women in the state of Paraná from 2000 to 2017

Objective: Breast cancer is one of the main challenges in Brazilian public health due to the high associated mortality. Mortality has different patterns according to age group, usually increasing with age. The demographic stability in Paraná, with the growth of the elderly population, has a direct impact on the epidemiology of this disease. This study aimed to assess, on a population-based basis, the rates and trends of mortality from breast cancer among the age groups of women in the state of Paraná from 2000 to 2017. Methods: A statistical descriptive retrospective series study was carried out to analyze, on a population-based basis, the trend in breast cancer mortality rates among the age groups of women in the state of Paraná, from 2000 to 2017. The trend analysis of annual mortality rates was carried out through the software and simple linear regression models. Results: The population-based analysis showed that women aged 45­54 and 55­64 years had the highest number of deaths during the study period. However, when calculating the mortality rates by age group, it was observed that the mortality pattern increases proportionally to the longevity of the female population in the state. Trend analyses indicated an upward trend in mortality among women aged 25­34 years throughout the study period. The same trend was observed in women aged 35­44 years, but in a shorter period, from 2005 to 2017. Conclusion: Mortality rates, per 100,000 women, were directly proportional to age, increasing with age, indicative of greater mortality from the disease in elderly women. There was a trend of increasing mortality, with statistical significance, in the age groups from 25 to 34 and 35 to 44. The others were considered stable trends.

Correlations between gestational age,birth weight and motor development in children with autism / 中华行为医学与脑科学杂志

Objective To explore the motor development and how it is influenced by gestational age and birth weight in children with autism,and provide evidence for the applications of motor development in the early diagnosis of autism. Methods A 1 ∶ 1 matched case-control study was conducted between 2012 and 2014. A total of 396 children under 5 years old with autism were enrolled in this study,their counterparts were healthy children 3 month younger/ older and with the same gender and residence. Guardians of partici-pants were investigated using self-designed childhood psychological and behavioral development and related factors questionnaire. EpiData 3. 0 software was used to establish the data base and SAS 9. 4 software was used for data analysis. Results 396 pairs were enrolled in this study which including 342 pairs of boys (86. 3%) and 54 pairs of girls(13. 7%),the gender ratio was 6. 33 ∶ 1; The average month age of case group was (39. 44±11. 99) months and (39. 96±12. 24) months for the control group. There was no signifi-cant difference observed in the distribution of birth weight(χ2=3. 888,P=0. 140) and gestational age specif-ic birth weight(χ2=0. 462,P=0. 794)between two groups. But the distribution of gestational age was signifi-cantly different(χ2=9. 476,P=0. 009) . Children with autism have significant delaying in motor develop-ment compared with healthy children at same age,which including head lifting(3. 50(1. 00) month),rolling (6. 00(3. 50)month),sitting(8. 00(2. 50)month),etc. Preterm birth could have an effect on head lifting, rolling and sitting in children with autism,and also was the risk factor of delaying occurrence of head lifting (OR=2. 911,95%CI=1. 491-5. 681);Small for gestational age( SGA) was also a risk factor of delaying in walking(OR=1. 703,95%CI=1. 053-2. 754). Conclusion Evident delaying of motor development is ob-served among children with autism. Both preterm and SGA are risk factors for delayed motor development. Thus,early recognization of abnormities in motor development should raise awareness among caregivers and children care workers and assist in early diagnosis of children with autism.

Age-Specific Cutoffs of the Sysmex UF-1000i Automated Urine Analyzer for Rapid Screening of Urinary Tract Infections in Outpatients

We investigated the usefulness of age-specific cutoffs for screening of urinary tract infections (UTIs) in Korean outpatients, using the automated urine analyzer UF-1000i (Sysmex, Kobe, Japan). We retrospectively reviewed outpatient medical records. Urine samples of 7,443 outpatients from January 2010 to December 2017 were analyzed using urine culture and UF-1000i. ROC curves were calculated for each UF-1000i parameter based on the culture results. There were 1,398 culture positive samples, 5,774 culture negative samples, and 271 contaminated samples. UF-1000i had an area under the curve of ≥0.9 in outpatients >15 years. The appropriate cutoffs, which are the sum of bacterial (B-A-C) and white blood cell (WBC) counts, were 297.10/µL (15–24 years), 395.65/µL (25–44 years), 135.65/µL (45–64 years), 67.95/µL (65–74 years), and 96.5/µL (≥75 years). B-A-C and WBC counts differed among the three most frequently identified bacteria (Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis). The UF-1000i system is useful for applying age-specific cutoffs to screen for UTIs, thereby preventing antibiotic abuse and reducing antibiotic resistance. Future studies can explore how its B-A-C and WBC counts can facilitate selection of empirical antibiotics by distinguishing between gram-positive and gram-negative bacteria.

O uso das taxas de crescimento por idade para identificação das principais etapas da transição demográfica no Brasil / The use of growth rates by age to identify the main stages of the demographic transition in Brazil / El uso de las tasas de crecimiento por edad para la identificación de las principales etapas de la transición demográfica en Brasil

A análise do conjunto de taxas específicas de crescimento por idade de uma população, proposta por Horiuchi e Preston (1988), é uma maneira alternativa de investigar o processo da mudança da estrutura etária de uma população, bem como de examinar possíveis "marcas" deixadas pela história demográfica de cada coorte. O objetivo deste trabalho é aplicar tal metodologia à população brasileira, discutindo grandes mudanças demográficas a partir da função corrente de crescimento populacional do Brasil, observada nos períodos entre 1970 e 1980, 1980 e 1990, 1990 e 2000, 2000 e 2010. A partir dos padrões da função de taxas específicas de crescimento, simulados por Horiuchi e Preston (1988) para descrever a estrutura das taxas específicas de crescimento para cada regime de mudança demográfica, foram avaliadas possíveis marcas da história demográfica presentes nas atuais coortes brasileiras. Os resultados demonstram que as informações contidas nas taxas específicas de crescimento são bastante elucidativas com relação aos efeitos de variações nos regimes demográficos, sendo de grande utilidade em populações cujas taxas vitais não são confiáveis ou estão indisponíveis.

The analysis of the set of age specific growth rates in a population, proposed by Horiuchi and Preston (1988), is an alternative way to examine the process of changing age structure as well as to examine potential "marks" left by the demographic history of each cohort. The objective of this study is to apply this methodology to the Brazilian population and discuss some of the major demographic changes on the basis of growth rates seen in Brazil since the 1970s. Based on patterns of specific growth rates simulated by these authors to describe the structure of specific growth rates for each type of demographic changes, we evaluate possible stages in the country's demographic history that may be present in the current cohorts. The results show that the information contained in specific growth rates are quite instructive regarding the effects of variations in demographic regimes and is very useful for populations where vital rates are unreliable or unavailable.

El análisis del conjunto de las tasas específicas de crecimiento por edad de una población, propuesto por Horiuchi y Preston (1988), es una forma alternativa de investigar el proceso de cambio de la estructura etaria de una población y de examinar las posibles "marcas" que ha dejado la historia demográfica de cada cohorte. El objetivo de este trabajo es aplicar esta metodología a la población brasileña, analizando los grandes cambios demográficos observados en el país desde 1970 hasta la actualidad sobre la base de las tasas de crecimiento poblacionales. A partir de los patrones de las funciones de las tasas específicas de crecimiento, simuladas por esos autores para describir la estructura de estas tasas para cada régimen de cambio demográfico, se evaluaron las posibles marcas que la historia demográfica ha dejado en las actuales cohortes brasileñas. Los resultados demuestran que la información contenida en las tasas específicas de crecimiento es bastante esclarecedora de los efectos de las variaciones en los regímenes demográficos, y es muy útil en poblaciones cuyas tasas vitales no son confiables o no están disponibles.

A hospital based study on reference range of serum prostate specific antigen levels.

Background & objectives: Serum prostate specific antigen (PSA) levels are known to vary with race and ethnicity, environmental factors, lifestyle, metabolic and physiologic changes and advancing age. This study was designed to determine age specific serum PSA level in healthy Indian men and its comparison with that reported in different populations of the world. Methods: A total of 1300 adult men who attended Executive Health Check-up programme in a tertiary care hospital in Haryana, India, were included in the study. Forty seven men were excluded from the analysis because of urological conditions affecting PSA values. Overall, 1253 men were analyzed for age specific PSA values. Results: The age specific reference range of serum PSA values was 0.71 ng/ml in those younger than 40 yr; 0.85 ng/ml in 40-49 yr; 1.13ng/ml in 50-59 yr group; 1.45 ng/ml in 60-69 yr group; 1.84 ng/ml in 70-79 yr group and 2.35 ng/ml in men older than 80 yr. Interpretation & conclusions: Our study provided the age-specific reference range of serum PSA in healthy men in India. The data suggested that the PSA levels were associated with increasing age.

Helminthiasis in School Aged Children in a Select Population in the Niger Delta.

Aim: Helminthiasis and its effects on the hematological parameters of school aged children in a select population in the Niger Delta. Study Design: A cross sectional study (Descriptive study). Place and Duration: The study was carried out in Emohua Local Government Area of Rivers State, between January–April 2011. Methodology: Concentration Method (Sedimentation) was used to examine the stool samples, Packed cell volume (PCV) was obtained by the use of hematocrit centrifugation and reader method; differential white blood count (WBC) was done according to Cheesbrough (2000). Results: Result of the study showed variability in the four gastrol-intestinal helminths among the 360 pupils investigated. Out of the 264(73.3%) positive samples, 142(53.7%) and 122(46.21%) were females and males respectively. Age specific gastroi intestinal worm load was relatively high in all age groups. This pattern of infection was attributed to favorable ecological factors that promote helminths transmission in the study area. However, the overall age related worm load showed that the 5-7 age group had relatively the highest parasite load in the study. The weight and height of infected pupils in relation to the uninfected varied statistically (p<0.05) across the age ranges but was not statistically different (p>0.05) within the age groups. A. lumbricoides (53.3%) was the most prevalent helminth amongst the infected. Conclusion: Overall mixed infection was (23.4%) while the 8-9 age range recorded the highest prevalence (28.2%). Sex related prevalence varied greatly in terms of percentage infection within and across the sexes. However, gastrointestinal parasitism was not significantly different (p>0.05) within the age groups but was significantly different (p<0.05) between the sexes. PCV values were below the normal range in both the infected uninfected in the study group indicating poor nutritional status of the population.

Analysis of age-specific prostate specific antigen and related parameters in 22 055 elderly men / 中华泌尿外科杂志

[Abstract] Objective To define the age-specific normal reference values of prostate specific antigen (PSA) and related parameters in Chinese middle-aged and elderly men.Methods From April 2007 to November 2011,serum PSAs of over 22 055 men aged more than 40 years old in our medical examination center were statistically analyzed.The men was divided into five groups by a 10-year-old interval.Total PSA (tPSA),free PSA (fPSA) and prostate ultrasound results were recorded.The free-total PSA ratio (f/t),PSA density (PSAD) and PSA velocity (PSAV) were calculated.By convention,the 95th percentile (P95)was used as the upper limit value,and the 5th percentile (P5) as the lower limit value.Results The tPSAs were positively correlated with age (r=0.349,P＜0.001).f/t was negatively correlated with age (r=-0.154,P＜0.01).Although f/t was significantly different (P＜0.001) among each age group,P5 of all groups were 0.18.PSAD was significantly different (P＜0.001) between men over and under 70 years,with P95 as 0.09 and 0.15,respectively.PSAD had a positive correlation with age (r =0.263,P＜0.01).The significant difference of PSAV raised between men over and under 60 years,with P95 as 0.21 and 0.58,respectively.PSAV was positively correlated with age (r=0.130,P＜0.01).Conclusions PSA,PSAD and PSAV are positively correlated with age,while f/t is negatively correlated with age.The normal range of f/tis 0.18-1.00 for Chinese men over 40 years old.PSAD's normal ranges are ＜0.09 and ＜0.15 in Chinese men over and under 70 years,respectively.The normal range of PSAV are ＜0.21 and ＜0.58 for Chinese men over and under 60 years,respectively.

The changing gaps of life expectancy on genders in urban cities of China, from 2005 to 2010 / 中华流行病学杂志

Objective To analyze the gender difference of life expectancy in urban people of China and to explore both age-specific and cause-specific contributions to the changing differences in life expectancy on genders.Methods Data on life expectancy (male and female) and mortality were obtained from the "Annual Statistics of public health in China".Male-female gender difference was analyzed by decomposition methodologies,including age-specific decomposition and the causespecific decomposition.Results Women had lived much longer than men in the Chinese urban citizens,with remarkable gains in life expectancy since 2005.Difference in gender reached a peak in 2007,with the gap of 5.3 years.Differences on mortality between men and women in the 60-79 age groups made the largest contribution (42％-47％) to the gap of 6 years on life expectancy in genders.With the widening of the gaps in gender on life expectancy between 2005 and 2007,faster declining of mortality among groups of women in age 0-1 age and over 75 years old groups made the largest contributions.Between 2007 and 2008,along with the reduction of gaps in gender,all the age groups except the 1-15 and 50-55 year-olds showed negative efforts.In 2009-2010,the widening gaps in gender on life expectancy were caused by the positive effect in the 60-70 age group.Among all the causes of death,cancer (1.638-2.019 years),circulatory diseases (1.271-1.606 years),respiratory diseases (0.551-0.800 years) made the largest contributions to the gender gap.33％-38％ of the gaps in gender were caused by cancer and among all the cancers,among which lung cancer contributed 0.6 years to the overall gap.Contribution of cancers to the gender gap was reducing,but when time went on it was mostly influenced by the narrowing effect caused by liver cancer on the gap in gender.Traffic accidents and suicidal issues were the external causes that influencing the gender gap and contributing 10.60％-15.78％ to the overall differentials.Conclusion Public health efforts in reducing the excess mortalities for cancer,circulatory and respiratory diseases,suicide,among men in particular,will further narrow the gender gap on life expectancy in the urban cities of China.

Incidence of colorectal cancer in Kashmir valley, India.

Background There is wide variation in the incidence of colorectal cancer globally and also within the same country among different racial or ethnic groups. The present population-based study was undertaken to determine the incidence of colorectal cancer in Kashmiri population which is non-migratory and ethnically homogeneous having stable food habits. Methods Over a period of one year, all newly diagnosed and histological proved cases of colorectal cancer in all possible areas, where such patients are diagnosed and treated were prospectively registered. Results A total of 212 cases of colorectal cancers were registered; of them 113 (53.3%) originated in the colon and other 99 (46.7%) in rectum. Male to female ratio was 1.2:1. The crude incidence rate of colorectal cancer was 3.65/ 100,000; it was 3.78 in males, and 3.50/100,000 in females. The incidence rates for colorectal cancer in Muslims and Hindus were different. The crude incidence rate for colorectal carcinoma was highest for district Srinagar 6.19/100,000 (urban area) and lowest for district Kupwara (rural area) 1.59/100,000. The highest numbers of cases were detected in the age group 55–59 years (n=34). The agespecific rate for colorectal carcinoma was highest in the age group 55–59 years (17.21/100,000), followed by 65–69 years (14.86/100,000). The age standardized incidence rate was 4.52/100,000 per year. The truncated age adjusted incidence rates in age group 35–64 years was 8.31/100,000; while that for colorectal carcinoma was 8.77/100,000 in males and 7.66/100,000 in females. Conclusion We conclude that the incidence of colorectal cancer in Kashmir valley is similar to that reported in the rest of India.

Early Motherhood and Contraceptive Use among Adolescents: A Study from Rajshahi District of Bangladesh.

Introduction: This paper employs various statistical methods to identify the factors associated with age at first motherhood and contraception use among the adolescence mothers in Rajshahi district of Bangladesh. Methods: To meets the objectives this study utilizes information from 1000 married adolescents of Rajshahi district within the age span (15-19 years). Results: We have observed adolescents mean age at first marriage and birth to be 15.0 and 16.4 years. This study reveals that the education, place of residence, occupation of husband and religion played the greatest roles on adolescent’s age at first motherhood. The analysis shows that, use of contraceptive among the adolescent’s was still very low. Slightly 56.7 per cent of the married adolescents were currently using any method of contraception. Among the factors determining contraceptive use among adolescents, education, visits of family planning workers and place of residence appears to be the most significant and positively associated with contraceptive use. Conclusions: The results indicate several policy options: (1) government has to take initial steps to strictly prohibit the early marriage with the proper application of existing law that would directly or indirectly rise the age at first birth among the adolescence; (2) programmes that encourage postponement of first birth after marriage through adoption of temporary contraceptive methods should be considered seriously ; (3) provide adolescents with information on the availability of family planning methods and their effectiveness; (4) increase the number of visits by family planning workers and their counseling about family planning methods help to motivate adolescents to accept family planning methods and use them effectively and (5)emphasize adolescents education to make a lasting impact on overall health of the adolescent mothers.

Diagnostic Approach of Lower GI Bleeding in Children / 대한소아소화기영양학회지

Lower GI bleeding is one of the common and difficult problems in the practice of general pediatrics. Causes of bleeding are various but somewhat age-specific in children. A specific diagnosis can usually be made with a accurate history taking, physical examination, included rectal exam, simple laboratory investigations, and appropriate diagnostic studies. Further evaluations can be unnecessary if the patient have a small amount of bleeding and stable vital sign. But precise investigation included abdominal sonography, endoscopy, Meckel's scan, and bleeding scan, are needed on a case by case. Treatment should be directed at the underlying cause. In most children, bleeding ceases spontaneously, and only supportive therapy is necessary. If there is evidence of hypovolemia, the patient must be hemodynamically stabilized, active bleeding stopped, and recurrent bleeding prevented. This review included age-specific cases such as Allergic proctocolitis, Meckel's diverticulum, Juvenile polyps, Henoch-scholein purpura, and Crohn disease, of lower gastrointestinal bleeding in children. Also it will assist the physician in determining appropriate assessment and treatment for children with lower GI bleeding through the usual cases.

Age-Specific Reference Ranges for Serum Prostate-Specific Antigen: Community-based Survey in Namhae Region / 대한비뇨기과학회지

PURPOSE: To establish the relationship between serum prostate specific antigen (PSA) concentration and age in a community-based population without clinically evident prostate cancer, a population based screening study was performed in a rural area in Southern Korea. MATERIALS AND METHODS: From January 1999 to December 1999, 1,278 volunteer men aged from 40 to 89 years in Namhae, Korea participated in a clinical examination that included a serum PSA determination (TANDEM-R assay), digital rectal examination and transrectal ultrasonography. The subjects who had clinical evidence of prostate cancer and high PSA concentration (>10ng/ml) were excluded. The PSA levels were compared with age using Pearson correlation and linear regression analysis. RESULTS: The serum PSA concentration correlated with patient age (r=0.129, p=0.001). The observed 95th percentile increased from 1.37ng/ml for subjects in the 40's to 6.18ng/ml for subjects in the 80'2. The reference range for serum PSA (95 percentile) for men in the 40's was 0.24 to 1.37ng/ml; for 50 to 59 years, 0.27 to 2.68ng/ml; for 60 to 69 years, 0.25 to 4.00ng/ml; for 70 to 79 years, 0.29 to 4.55ng/ml; and for 80 to 89 years, 0.31 to 6.18ng/ml. CONCLUSIONS: Our data showed that the serum PSA concentration directly correlated with patient age (Pearson correlation coefficient=0.129, P=0.001). Thus, rather than relying on a single reference range regardless of different age groups, it may be more appropriate to have age-specific reference ranges. Our data were lower than that of the Western data, and could provide an adjunctive information in interpreting PSA data in Korean men, especially in the elderly population.

The Age-specific Reference Ranges for Prostate-specific Antigen obtained from Health Promotion Center / 대한비뇨기과학회지

PURPOSE: We intend to define age-specific ranges for serum prostate-specific antigen (PSA) and to investigate the relationship of age to serum PSA in Korean healthy men. MATERIALS AND METHODS: From April 1992 to February 1997, 7,718 Korean men aged 30 to 79 years visited to Soonchunhyang health promotion center and were examined with serum PSA. We evaluated serum PSA of 2,321 Korean healthy men aged 50 to 79 years(1,943 aged 50 to 59 years, 292 aged 60 to 69 years, and 86 aged 70 to 79 years) using Hybritech Tandem-R aasay. Statistical analysis was performed by simple linear regression analysis using SPSS. RESULTS: Average serum PSA of 2,321 Korean healthy men was 1.25+/-1.02ng/ml, and mean value for serum PSA for men aged 50 to 59 years was 1.18+/-0.95ng/ml; for 60 to 69 years, 1.48+/-1.19ng/ml; and 70 to 79 years, 1.99+/-1.18ng/ml. Age-specific reference ranges for serum PSA for men aged 50 to 59 years were 0-3.1ng/ml; for 60 to 69 years, 0-3.9ng/ml; and for 70 to 79 years, 0-5.5ng/ml, respectively. Serum PSA concentration was correlated with age(r=0.35, p-value<0.05). CONCLUSIONS: The serum PSA concentration was correlated with age and age-specific reference ranges for serum PSA in Korean healthy men were lower than those in white men. Therefore, we suggest that age-specific reference ranges for serum PSA in Korean should be defined in order to increase the detection rate of localizing prostate cencer in younger ages, and to decrease the risk of missing prostate cancer in older ages.

Age-specific Reference Ranges for Prostate Specific Antigen from a Health Center in Korea / 대한비뇨기과학회지

PURPOSE: The PSA is believed to be the most useful tumor marker available for prostate cancer. Several investigations were published which established the role of age-specific reference ranges in screening and early detection of prostate cancer. This study is to determine age-specific reference ranges for serum PSA concentration in a health center of Korea in comparison with those of other races. MATERIALS AND METHODS: Between June, 1996 and May, 1997, a total of 18,928 Korean men aged 40 to 79 years who were examined in the health center of Asan Medical Center had serum PSA screening tests for prostate cancer. There were 9 cases of prostate cancer. Serum PSA concentrations of whom had no prostate cancer were determined with Tandem-R PSA assay (Hybritech). Descriptive statistics, including the median values, 25th, 75th and 95th percentiles of the distribution of serum PSA concentration, were calculated for 5-year and 10-year age-groups from aged 40 through 79. A regression model was used to characterize the distribution of the logarithm of serum PSA concentration by age. RESULTS: The serum PSA concentration correlated directly with age(r=0.19; p<0.05). Adjusted for age, the serum PSA concentration was lower for Korean men than for Caucasian, black men or Japanese men. Thus the recommended age-specific reference ranges(95th percentile) for serum PSA concentration for Korean men of our health center were lower as well; 0.0-2.1 ng/ml for 40-49 years, 0.0-2.5 ng/ml for 50-59 years, 0.0-3.0 ng/ml for 60-69 years, 0.0-3.6 ng/ml for 70-79 years. CONCLUSIONS: These findings suggest that the age-specific reference ranges for serum PSA concentration are lower for Korean men than for Caucasian or black men. Newly proposed age-specific reference ranges by our institute would be more valuable for Korean men.

Age-specific Reference Range of Prostate-specific Antigen in Healthy Men Received Multipathic Health Checkup Center / 대한비뇨기과학회지

PURPOSE: This study is to determine age-specific reference range of serum concentration of prostate-specific antigen(PSA) in each decades of age for whom PSA levels were checked in our Multipathic Health Checkup Center. MATERIALS AND METHODS: Between February 1996 and August 1998, the serum PSA of 10,691 men aged 20 to 79 years were checked from Multipathic Health Checkup Center. All cases of lower urinary tract infection(>4WBC/HPF in urinalysis) were excluded from the analysis. PSA was measured by Enzyme Immuno-Assay(AxSYM kit, Abbott Co.) techniques. Patients were grouped according to age by decade: group 20`s(n=941), group 30`s(n=3,963), group 40`s(n=3,607), group 50`s(n=1,735), group 60`s(n=392) and group 70`s(n=53). RESULTS: Based on linear regression analysis, serum PSA concentration was correlated with patient age significantly(r=0.091, p<0.005). The mean PSA values(ng/ml) of each age groups were 20`s: 0.927+/-.660, 30`s: 0.931+/-.664, 40`s: 0.951+/-.715, 50`s: 1.035+/-.883, 60`s: 1.369+/-.607 and 70`s: 2.244+/-.317. The upper limits of PSA(mean+2SD) according to age were 20`s: 2.25ng/ml, 30`s: 2.26ng/ml, 40`s: 2.38ng/ml, 50`s: 2.80ng/ml, 60`s: 4.58ng/ml and 70`s: 8.88ng/ml. CONCLUSIONS: These findings confirmed earlier observations that serum PSA were age-dependent and age-specific, and it were lower for Korean men than for white men. The age-specific reference ranges for Korean men should be established, and then the PSA assay could become more efficient as a screening test for prostatic cancer.

Age-specific Reference Ranges for Serum Prostate-specific Antigen(PSA): Community-based Survey in Chungbuk Region / 대한비뇨기과학회지

PURPOSE: To establish the relationship between serum prostate specipic antigen(PSA) concentration and age in a community-based population without clinically evident prostate cancer. MATERIALS AND METHODS: From September 1996 to August 1997, Volunteer 694 men aged 40 to 79 years from Chungbuk, Korea participated in a clinical examination that included a serum PSA determination (ELSA-PSAR immunoradiometric assay), digital rectal examination and transrectal ultrasonography, with patients who had clinically evidence of prostate cancer and high PSA concentration (>10ng/ml) excluded. RESULTS: The serum PSA concentration correlated with patient age (r=0.275, p<0.001) in that the observed 95th percentile increased from 2.1ng/ml for subjects of 40 to 49 year of age to 5.62ng/ml for subjects of 70 to 79 year of age. Variability in serum PSA concentrations also increased with age. The recommanded reference range for serum PSA (95 percentile) for men aged 40 to 49 years was 0.40 to 2.22ng/ml; for 50 to 59 years, 0.40 to 3.36ng/ml; for 60 to 69 years, 0.40 to 4.1ng/ml; for 70 to 79 years, 0.70 to 5.62ng/ml. CONCLUSIONS: Our data showed that the serum PSA concentration directly correlated with patient age (r=0.275, P<0.001). Thus, rather than relying on a single reference range regardless of different age groups, it may be more appropriate to have age-specific reference ranges. These range could provide a specificity near 95%. Our data reveals lower values compared to the western data. Thus, it would be appropriate to apply the age-specific reference ranges for Koreans.

Age-specific Reference Ranges for Prostate-specific Antigen from a Community-based Study / 대한비뇨기과학회지

PURPOSE: To analyze the relationship of age to serum prostate-specific antigen (PSA) levels among Koreans without clinically evident prostate cancer in a community-based study. MATERIALS AND METHOD: A total of 375 healthy men aged 50 to 79, residing in the small farming villages of Jeong-Eup county, Korea were examined with serum PSA(Hybritech Tandem-R) and digital rectal examination. One case of patient with prostate cancer was excluded. RESULTS: The serum PSA concentration is correlated with patient age(In PSA=-1.56+0.0257 x Age, r=0.32, p-value<0.0001). The recommended age-specific reference ranges of serum PSA(95th percentile) for men aged 50-59 years is 0-2.80ng/m1; for 60-69 years,0-3.56ng/m1; and for 70-79 years, 0-4.57ng/m1. CONCLUSIONS: The serum PSA concentration is correlated with patient age in Korean men and the age-specific PSA reference ranges for Korean are lower than those for Caucasian.

Age-specific Reference Ranges and Cutoff Point of Prostate Specific Antigen in Normal Korean Men / 대한비뇨기과학회지

PURPOSE: Nevertheless, the lack of sensitivity and specificity in the detection of prostate cancer, the serum prostate specific antigen(PSA) is one of the commonly used diagnostic modality for detecting prostate cancer. But using PSA cutoff point greater than 4.0ng/ml and the normal age-specific reference ranges established by Oesterling and associates(age 40 to 49 years, 0 to 2.5ng/ml, age 50 to 59, 0 to 3.5ng/ml; age 60 to 69, 0 to 4.5ng/ml; age 70 to 79, 0 to 6.5ng/ml) is not certain whether it is preferable to Korean men. We measured the serum PSA in order to know the normal age-specific reference ranges and the cutoff point of PSA in 2,098 health Korean men. MATERIALS AND METHODS: The data were analysed retrospectively in 2,098 men (range of age 40-79) who visited our hospital health care center without voiding-related symptoms between November 1995 to December 1997. Serum PSA was measured by chemiluminescent immunometric assay. RESULTS: Using 95th percentile of PSA, the normal age-specific reference ranges are: age 40 to 49 years, 0 to 2.2ng/ml; age 50 to 59, 0 to 2.5ng/ml; age 60 to 69,0 to 3.5ng/ml; age 70 to 79,0 to 6.0ng/ml. Cutoff point of PSA is 2.6ng/ml(95th percentile of PSA). CONCLUSIONS: Our study suggested that the age-specific reference ranges and cutoff point of PSA in normal Korean men are lower than white men.

Clinical Significance of Age-Specific Reference Range of PSA / 대한비뇨기과학회지

The serum PSA concentration is directly correlated with patient age and prostatic volume. Thus, rather than rely on a single reference range for men of all age group, it is more appropriate to have age-specific reference ranges. We define the cancer-free population as men with a PSA less than or equal to 4.0ng/ml and nonsuspicious digital rectal examination, and those with an abnormality in either parameter with a nonmalignant prostate biopsy. A total of 905 men was recruited for a prostate cancer detection study using serum PSA and digital rectal examination, of whom 869 fulfilled our criteria of cancer-free. The upper limits for PSA(mean +2 standard deviations) by age were 2.89ng/ml in the 40 to 49-year group, 4. 67ng/ml in the 50 to 59-year group, 5.49ng/ml in the 60 to 69-year group and 6.48ng/ml in the 70 to 79-year group. It is the purpose of our study to know that how accurate our definition of normal as evidenced by a lack of cancer in men with a normal digital rectal examination and PSA between 4.0 and the derived upper limit of normal is. The apparent accuracy of these new limits is strong in the 50 to 69-year group but it declines in the next decade. The data support further attempts at using PSA, age and digital rectal examination to establish selection criteria for prostate biopsy with adequate specificity.