OBJECTIVES: To evaluate the distribution of serum prostate-specific antigen (PSA) levels as a function of age in men with no evidence of prostate cancer who visited urological clinics. METHODS: Simultaneous measurements of total PSA and PSA-alpha-1-antichymotrypsin (PSA-ACT) were performed on patients who presented at urological clinics in Japan. After excluding 490 patients because of follow-up biopsy findings indicating prostate cancer, patients' history of prostatic surgery and medication affecting the serum PSA level, 1520 patients with PSA levels of less than 20.0 ng/mL were available for the study. RESULTS: Medians (95th percentile) of the total PSA levels were 0.9 (4.7), 1.2 (5.6), 1.7 (11.0), 2.1 (9.8) and 2.8 (11.0) ng/mL in men in their 40s (n = 37), 50s (n = 211), 60s (n = 488), 70s (n = 609) and 80s (n = 175), respectively, whereas those of PSA-ACT were 0.5 (2.9), 0.7 (3.7), 1.1 (7.4), 1.2 (5.9) and 1.6 (6.4) ng/mL, respectively. Both total PSA and PSA-ACT increase with aging, although comparison between the 10-year age groups showed a significant difference in the two molecular forms only between men in their 50s and 60s. CONCLUSIONS: The PSA ranges of men who visited urological clinics were higher than those of men participating in prostate cancer screening programs reported in other published studies. An age-associated increase in PSA similar to screening populations was also observed in urological outpatients. The results of the present study indicate that age-adjusted PSA cut-off levels can be used in outpatient settings, although the PSA reference value derived from the screening population should be carefully applied to symptomatic men of clinical practices.
OBJECTIVES: To evaluate the distribution of serum prostate-specific antigen (PSA) levels as a function of age in men with no evidence of prostate cancer who visited urological clinics. METHODS: Simultaneous measurements of total PSA and PSA-alpha-1-antichymotrypsin (PSA-ACT) were performed on patients who presented at urological clinics in Japan. After excluding 490 patients because of follow-up biopsy findings indicating prostate cancer, patients' history of prostatic surgery and medication affecting the serum PSA level, 1520 patients with PSA levels of less than 20.0 ng/mL were available for the study. RESULTS: Medians (95th percentile) of the total PSA levels were 0.9 (4.7), 1.2 (5.6), 1.7 (11.0), 2.1 (9.8) and 2.8 (11.0) ng/mL in men in their 40s (n = 37), 50s (n = 211), 60s (n = 488), 70s (n = 609) and 80s (n = 175), respectively, whereas those of PSA-ACT were 0.5 (2.9), 0.7 (3.7), 1.1 (7.4), 1.2 (5.9) and 1.6 (6.4) ng/mL, respectively. Both total PSA and PSA-ACT increase with aging, although comparison between the 10-year age groups showed a significant difference in the two molecular forms only between men in their 50s and 60s. CONCLUSIONS: The PSA ranges of men who visited urological clinics were higher than those of men participating in prostate cancer screening programs reported in other published studies. An age-associated increase in PSA similar to screening populations was also observed in urological outpatients. The results of the present study indicate that age-adjusted PSA cut-off levels can be used in outpatient settings, although the PSA reference value derived from the screening population should be carefully applied to symptomatic men of clinical practices.