Age-specific reference ranges for prostate specific antigen-total and free in patients with prostatitis symptoms and patients at risk.

BACKGROUND

Prostate-specific antigen (PSA) is a tumor marker helpful in the diagnosis and follow-up of prostate cancer. However, PSA level may rise due to other causes than prostate cancer such as benign prostatic hyperplasia (BPH), acute prostatitis, chronic bacteria and a bacterial prostatitis. Total serum PSA (TPSA) and free prostate-specific antigen (FPSA) levels of patients with prostatitis symptoms as well as these levels in male population at risk but without clinical prostatic diseases (>40-years-old) with regard to age should be documented in order to increase the sensitivity and specificity of PSA in prostate carcinoma.

METHODS

A comprehensive urological examination was performed on 1150 male patients over the age of 40 with prostatism symptoms from the random-sample community based in with no diagnostic prostate cancer. Men with PSA level 4.1 ng/ml or greater were referred for biopsy and those with positive biopsies or with medical record, cancer registry, or self-reported evidence of prostate cancer were excluded. Data were studied as a function of age to determine the usefulness of measuring TPSA and FPSA as screening tests for risk patient's cancer.

RESULTS

Because of the greater variability at older ages, the 95th percentile increased faster than the median, the following age-specific reference ranges of TPSA and FPSA for patients with prostatism symptoms were as follows: 3.1 and 0.7 ng/ml for the age group 40-49 years, 4.4 and 0.89 ng/ml for the age group 50-59 years, 5.6 and 1.3 ng/ml for the age group 60-69 years, and 6.3 and 1.8 ng/ml for age group 70-79 years. There was a continuous increase in TPSA and FPSA means and medians with significant correlation (P<0.001, P<0.005) and advancing age group. The aim of this study was to find out age-specific values and ranges of TPSA and FPSA in patients with prostatism symptoms to ensure low false-positive biopsy rates.