Age-specific Reference Ranges for Serum Prostate-specific Antigen(PSA): Community-based Survey in Chungbuk Region

Woo, Seung Hyo; Lee, Jae Won; Lee, Sang Cheol; Kim, Yong Tae; Lee, Hyung Lae; Kim, Wun Jae

Abstract

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.