Korean J Urol.  2007 Aug;48(8):782-788. 10.4111/kju.2007.48.8.782.

Change of Serum Prostate-specific Antigen with Age in Korean Men

Affiliations
  • 1Department of Urology, National Police Hospital, Seoul, Korea.
  • 2Department of Urology, University of Ulsan College of Medicine, Seoul, Korea. cskim@amc.seoul.kr

Abstract

PURPOSE
Prostate-specific antigen(PSA) is believed to be the most useful tumor marker available for prostate cancer. Our intension was to establish the normal pattern of PSA changes with age and initial PSA to provide baseline data from which disease progression might be detected.
MATERIALS AND METHODS
Patients, who received serum PSA screening test more than twice, between January 1997 and December 2005, at the health center of Asan Medical Center, were selected for this investigation. The PSA levels of 27,439 adult males, aged between 20 and 79 years, with no known prostate disease, were determined using the Tandem-R PSA assay (Hybritech). The PSA values were determined at the baseline and after 1 to 8 years. To estimate the increase in the level of serum PSA according to age, a one-way ANOVA test was carried out. Every change in an individual's PSA level was compiled to plot curves of the PSA according to the initial age and initial PSA. The PSA doubling times were also calculated with different PSA values at different ages.
RESULTS
The mean PSA levels according to age steadily increased, and were directly correlated with age(p<0.001). These increases were greater for those in their fifties and most severe after their sixties. The future PSA and doubling time of an individual can be predicted based on his age and known history of PSA.
CONCLUSIONS
The model indicates the expected rises in the PSA level in relation to age and the PSA doubling times in healthy Korean men. This will provide baseline data from which disease progression might be detected.

Keyword

Prostate-specific antigen; Age groups; Korea

MeSH Terms

Adult
Chungcheongnam-do
Disease Progression
Humans
Korea
Male
Mass Screening
Prostate
Prostate-Specific Antigen*
Prostatic Neoplasms
Prostate-Specific Antigen

Figure

  • Fig. 1 Mean prostate-specific antigen (PSA) and reference range (95th and 97.5th percentile) curve in relation to age.

  • Fig. 2 Graphs for predicted prostate-specific antigen (PSA) values and reference ranges.


Reference

1. Morote Robles J, Ruibal Morell A, Palou Redorta J, de Torres Mateos JA, Soler Rosello A. Clinical behavior of prostatic specific antigen and prostatic acid phosphatase: a comparative study. Eur Urol. 1998. 14:360–366.
2. Oesterling JE. Prostate specific antigen: a critical assessment of the most useful tumor marker for adenocarcinoma of the prostate. J Urol. 1991. 145:907–923.
3. Wang MC, Valenzuela LA, Murphy GP, Chu TM. Purification of a human prostate specific antigen. Invest Urol. 1979. 17:159–163.
4. Dalkin BL, Ahmann FR, Kopp JB. Prostate specific antigen levels in men older than 50 years without clinical evidence of prostatic carcinoma. J Urol. 1993. 150:1837–1839.
5. Babaian RJ, Miyashita H, Evans RB, Ramirez EI. The distribution of prostate specific antigen in men without clinical or pathological evidence of prostate cancer. J Urol. 1992. 147:837–840.
6. Catalona WJ, Smith DS, Ornstein DK. Prostate cancer detection in men with serum PSA concentrations of 2.6 to 4.0ng/mL and benign prostate examination. Enhancement of specificity with free PSA measurements. JAMA. 1997. 277:1452–1455.
7. Sershon PD, Barry MJ, Oesterling JE. Serum prostate-specific antigen discriminates weakly between men with benign prostatic hyperplasia and patients with organ-confined prostate cancer. Eur Urol. 1994. 25:281–287.
8. 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.
9. Oesterling JE, Jacobsen 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.
10. Smith DS, Catalona WJ. Rate of change in serum prostate specific antigen levels as a method for prostate cancer detection. J Urol. 1994. 152:1163–1167.
11. Prestigiacomo AF, Stamey TA. Physiological variation of serum prostate specific antigen in the 4.0 to 10.0ng/ml range in male volunteers. J Urol. 1996. 155:1977–1980.
12. Im YJ, Hong SJ, Chung BH. Clinical application of free to total PSA ratio in detection of prostate cancer in Korean men: lower cut-off value. Korean J Urol. 2004. 45:753–757.
13. Lee SC, Lee SC, Kim WJ. Value of PSA density, PSA velocity and percent free PSA for detection of prostate cancer in patients with serum PSA 4-10ng/ml patients. Korean J Urol. 2004. 45:747–752.
14. 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. 20:671–680.
15. Anderson JR, Strickland D, Corbin D, Bymes JA, Zweiback E. Age-specific reference ranges for serum prostate-specific antigen. Urology. 1995. 46:54–57.
16. Oh SJ, Kim DY, Jeong H, Kwak C, Ji JR, Park MS, et al. Age-related serum prostate specific antigen levels in Korean men. Korean J Urol. 1999. 40:715–721.
17. Mettlin C, Murphy GP, Lee F, Littrup PJ, Chesley A, Babaian R, et al. Characteristics of prostate cancer detected in the American Cancer Society-National Prostate Cancer Detection Project. J Urol. 1994. 152:1737–1740.
18. Jeon HJ, Kim YS, Kang DR, Nam CM, Kim CI, Seong DH, et al. Age-specific reference ranges for serum prostate-specific antigen in Korean men. Korean J Urol. 2006. 47:586–590.
19. 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.
20. Kim GJ, Park SS. Age-specific reference range of prostate-specific antigen in healthy men received multipathic health checkup center. Korean J Urol. 1999. 40:1305–1310.
21. Ku JH, Kim JM, Song YS, Kim ME, Lee NK, Park YH, et al. The age-specific reference ranges for prostate-specific antigen obtained from health promotion center. Korean J Urol. 1999. 40:1152–1156.
22. 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.
23. Woo SH, Lee JW, Lee SC, Kim YT, Lee HL, Kim WJ. Age-specific reference ranges for serum prostate-specific antigen (PSA): community-based survey in Chungbuk region. Korean J Urol. 1999. 40:441–445.
24. Bosch JL, Tilling K, Bohnen AM, Donovan JL. Establishing normal reference ranges for PSA change with age in a population-based study: the Krimpen study. Prostate. 2006. 66:335–343.
Full Text Links
  • KJU
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr