Assessment of serum prostate specific antigen in childhood

To investigate serum prostate specific antigen (PSA) levels with age and sex in childhood.

This prospective study included 205 children (123 boys, 82 girls; mean age 59.27 months, sd 3.78, range 2 days to 204 months) with no urogenital or endocrine disorders. PSA levels were measured using a highly sensitive, "third-generation" PSA (time-resolved immunofluorometric) assay, able to detect PSA levels of > or = 1 ng/L (0.001 ng/mL). Children were divided into four groups by age, i.e. A (0-12 months; 34 boys/20 girls); B (13-48, 37/21); C (49-144, 41/32); and D (> 144, 11/9). The data were analysed statistically using analysis of variance.

An accurate measurement of PSA was possible in both sexes using the assay. The median (sd, range) PSA level in boys was 38.41 (1.318, 1-2768) ng/L, and in girls 4.059 (1.392, 1-287) ng/L. There were no significant differences between girls at all age groups, or between the sexes for groups A-C, but levels were significantly higher in boys in group D (30 times that in girls), at 142.59 (1.53) and 4.85 (1.58) ng/L (P < 0.01).

PSA levels do not differ significantly between boys and girls until 12 years old, after which there is a significant and steep increase in PSA in boys, reflecting the development of the prostate. Assessing PSA in children could be used as a potential marker in the diagnosis and follow-up of urogenital disorders.