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 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 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 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.

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.

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.