Korean J Urol.  2006 Jun;47(6):586-590. 10.4111/kju.2006.47.6.586.

Age-Specific Reference Ranges for Serum Prostate-Specific Antigen in Korean Men

Affiliations
  • 1Department of Urology&Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. ydchoi@yumc.yonsei.ac.kr
  • 2Department of Urology, Ilsan Hospital, National Health Insurance Corporation, Ilsan, Korea.
  • 3Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Urology, College of Medicine, Keimyung University, Daegu, Korea.
  • 5Department of Urology, Inha University, Incheon, Korea.
  • 6Department of Urology, Ajou University, Suwon, Korea.
  • 7Department of Urology, Ulsan University, Ulsan, Korea.
  • 8Department of Urology, Inje University, Busan, Korea.
  • 9Department of Urology, Hallym University, Chuncheon, Korea.

Abstract

PURPOSE: The level of serum prostate-specific antigen (PSA) varies according to both age and race. It is known that the level of PSA increases with age, and that Asians have a lower incidence of prostate cancer and levels of PSA than Caucasians. In this study, the variation in the serum PSA level in samples collected from general populations were used to find an actual standard age-specific PSA reference range for Koreans.
MATERIALS AND METHODS
Patients who received serum PSA level check-ups, between November 1998 and July 2005, at 8 domestic hospitals, were selected for the investigation. The PSA levels of 120,439 adult males, aged between 30 and 80 years, were measured, and those lower than 10ng/ml were analyzed. To estimate the increase in the level of serum PSA according to age, a simple linear regression analysis was carried out.
RESULTS
The mean PSA level reference ranges according to age were 1.88, 1.92, 2.37, 3.56 and 5.19ng/ml for those in their thirties, forties, fifties, sixties and seventies, respectively. The rates of PSA change were 0.0023, 0.0175 and 0.0499 for those in their forties, fifties and sixties, respectively, indicating the rates of PSA level change increase steady with age, but these increases are greater for those in their fifties and most severe after their sixties. The level of age-specific PSA reference in Korean men was lower than that of men from Western countries.
CONCLUSIONS
The age-specific PSA reference levels, as found in pre-existing literature, showed differences between races, with the overall reference levels being low for domestic data. The standard reference level of age-specific PSA for the screening of prostate cancer may be lower in Korean men than those from Western countries.

Keyword

Prostate-specific antigen; Age groups; Screening; Reference range

MeSH Terms

Adult
Asian Continental Ancestry Group
Continental Population Groups
Humans
Incidence
Linear Models
Male
Mass Screening
Prostate-Specific Antigen*
Prostatic Neoplasms
Reference Values*
Prostate-Specific Antigen

Figure

  • Fig. 1 Regression curve between age and serum prostate-specific antigen (PSA).


Reference

1. Parker SL, Tong T, Bolden S, Wingo PA. Cancer statistics, 1997. CA Cancer. J Clin. 1996. 46:5–27.
2. Brawley OW. Prostate carcinoma incidence and patient mortality: the effects of screening and early detection. Cancer. 1997. 80:1857–1863.
3. Wang MC, Valenzuela LA, Murphy GP, Chu TM. Purification of a human prostate specific antigen. Invest Urol. 1979. 17:159–163.
4. Oesterling JE. Prostatic specific antigen: a critical assessment of the most useful tumor marker for adenocarcinoma of the prostate. J Urol. 1991. 145:907–923.
5. Partin AW, Oesterling JE. The clinical usefulness of prostate specific antigen: update 1994. J Urol. 1994. 152:1358–1368.
6. Glenski WJ, Malek RS, Myrtle JF, Oesterling JE. Sustained, substantially increased concentration of prostate-specific antigen in the absence of prostatic malignant disease: an unusual clinical scenario. Mayo Clin Proc. 1992. 67:249–252.
7. Hudson MA, Bahnson RR, Catalona WJ. Clinical use of prostate specific antigen in patients with prostate cancer. J Urol. 1989. 142:1011–1017.
8. Oesterling JE, Cooner WH, Jacobsen SJ, Guess HA, Lieber MM. Influence of patient age on the serum PSA concentration. An important clinical observation. Urol Clin North Am. 1993. 20:671–678.
9. Collins GN, Lee RJ, McKelvie AC, Rogers AC, Hehir M. Relationship between prostate specific antigen, prostate volume and age in the benign prostate. Br J Urol. 1993. 71:445–450.
10. Weinrich MC, Jacobsen SJ, Weinrich SP, Moul JW, Oesterling JE, Jacobson D, et al. Reference ranges for serum prostate-specific antigen in black and white men without cancer. Urology. 1998. 52:967–973.
11. Chung BH, Hong SJ, Lee SE, Lee DH. Serum PSA concentration, prostate specific antigen density with aging. Korean J Urol. 1996. 37:257–262.
12. Lee TK, Chung TG, Kim CS. Age-specific reference ranges for prostate specific antigen from a health center in Korea. Korean J Urol. 1999. 40:583–588.
13. Oesterling JE, Jacobson SJ, Chute CG, Guess HA, Girman CJ, Panser LA, et al. Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges. JAMA. 1993. 270:860–864.
14. Dalkin BL, Abmann FR, Kopp JB. Prostate specific antigen levels in men older than 50 years without clinical evidence of prostatic cancer. J Urol. 1993. 150:1837–1839.
15. Choi YD, Hong SJ, Rha KH, Kim BH, Cha KB, Song JS, et al. Age-specific reference ranges for serum prostate-specific antigen: community-based survey in Namhae region. Korean J Urol. 2001. 42:834–839.
16. Robles JM, Morell AR, Redorta JP, de Torres JA, Resello SA. Clinical behavior of prostatic specific antigen and prostatic acid phosphatase: a comparative study. Eur Urol. 1998. 14:360–366.
17. Cooner WH. Definition of the ideal tumor marker. Urol Clin North Am. 1993. 20:575–579.
18. Babaian RJ, Miyashita H, Evana RB, Ramirez EI. The distribution of prostate specific antigen in men without clinical or pathological evidence of prostate cancer: relationship to gland volume and age. J Urol. 1992. 147:837–840.
19. Benson MC, Whang IS, Pontuck A, Ring K, Kaplan SA, Olsson CA, et al. Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer. J Urol. 1992. 147:815–816.
20. Carter HB, Pearson JD, Metter EJ, Brant LJ, Chan EW, Andress R, et al. Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease. JAMA. 1992. 267:2215–2220.
21. Kao CH. Age-related free PSA, total PA and free PSA/total PSA ratios: establishment of reference ranges in Chinese males. Anticancer Res. 1997. 17:1361–1365.
22. Smith DS, Catalona WJ. The nature of prostate cancer detected through prostate specific antigen based screening. J Urol. 1994. 152:1732–1736.
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