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Related Experiment Videos

Prostate-specific antigen testing of older men.

H B Carter1, P K Landis, E J Metter

  • 1Department of Urology, The Johns Hopkins University School of Medicine, The James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, MD 21287-2101, USA. hcarter@jhmi.edu

Journal of the National Cancer Institute
|October 21, 1999
PubMed
Summary

Older men with low prostate-specific antigen (PSA) levels may benefit from less frequent PSA testing. Reducing screening intensity in older men with low PSA levels is unlikely to increase undetected prostate cancer rates.

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Area of Science:

  • Urology
  • Geriatric Medicine
  • Oncology

Background:

  • Elevated serum prostate-specific antigen (PSA) levels predict prostate cancer diagnosis.
  • Investigating reduced PSA testing intensity for older men with low baseline PSA is crucial due to potentially lower cancer detection rates.

Purpose of the Study:

  • To evaluate the association between age, baseline PSA level, and prostate cancer detection rates.
  • To test the hypothesis that older men with low PSA levels may require less intensive PSA testing.

Main Methods:

  • Prospective cohort study of men aged 60 or 65 years with serial PSA measurements until age 75 or prostate cancer diagnosis.
  • Defined PSA conversion as a PSA level > 4.0 ng/mL.
  • Analyzed cancer cases and non-cancer subjects based on baseline PSA and age.

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Main Results:

  • In the 60-year-old cohort, all cancer cases had baseline PSA > 0.5 ng/mL.
  • In the 65-year-old cohort, 14 of 15 detected cancers had baseline PSA ≥ 1.1 ng/mL.
  • Discontinuing PSA testing at age 65 in men with PSA ≤ 0.5 ng/mL would still detect 100% of cancers by age 75.

Conclusions:

  • Decreasing screening intensity in older men with low PSA values may not increase the risk of undetected prostate cancer.
  • These findings support individualized PSA screening strategies based on age and baseline PSA levels.