Age‐associated increase of prostate‐specific antigen in a high level of men visiting urological clinics

Abstract

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-a -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 ageassociated 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.

The association between metabolic syndrome and prostate‐specific antigen levels

“…The PSA test is used worldwide as a screening tool, as part of the diagnostic workup to rule out prostate cancer, and is used in the management of the disease after diagnosis. PSA levels may be affected by many factors, such as age, prostate volume, and obesity, and the sensitivity of the PSA test has been questioned 1–9 . With regard to improving the accuracy of the PSA test, many factors have been considered.…”

“…Remarkable increases in the incidence of prostate cancer were noted in the early 1990s in many countries, largely due to the widespread use of prostate‐specific antigen (PSA) testing. The high tissue specificity of PSA makes it one of the most useful tumor markers in medicine, facilitating diagnosis, staging, and monitoring of prostatic disease and treatment; yet PSA levels may be affected by many factors, such as age, prostate volume, and obesity 1–9 . With the introduction of PSA testing in prostate cancer screening programs, the sensitivity of PSA has been questioned.…”

Body mass index influences prostate‐specific antigen in men younger than 60 years of age

“…PSA levels may be affected by many factors, such as age, prostate volume, and obesity. [1][2][3][4] Although the etiology of prostate hyperplasia has not been fully elucidated , metabolic disturbances induced by obesity, such as androgens, estrogens SHBG, hyperinsulinemia, and IGF-1, may induce prostate enlargement. 18,20,21 Our study populations were enrolled when having a routine health checkup.…”

“…The high tissue specificity of PSA makes it one of the most useful tumor markers in medicine, facilitating the diagnosis, staging, and monitoring of prostatic disease and treatment. Still, PSA levels may be affected by many factors, such as age, prostate volume, and obesity 1–4 . Obesity is associated with many chronic diseases, including cardiovascular disease, diabetes, and certain cancers, 5 but the effect of obesity on PSA remains controversial.…”

“…Still, PSA levels may be affected by many factors, such as age, prostate volume, and obesity. [1][2][3][4] Obesity is associated with many chronic diseases, including cardiovascular disease, diabetes, and certain cancers, 5 but the effect of obesity on PSA remains controversial. Several recent studies reported that PSA levels were approximately 0.2-0.4 ng/mL lower among otherwise healthy but obese men compared to non-obese males.…”