The association between total prostate specific antigen concentration and prostate specific antigen velocity

Area of Science:

• Urology
• Oncology
• Biomarkers

Background:

• Prostate specific antigen (PSA) velocity > 2 ng/ml/year is linked to poorer survival after prostate cancer treatment.
• Initial PSA levels may influence the likelihood of reaching this PSA velocity threshold.
• Understanding the relationship between PSA and PSA velocity is crucial for risk stratification.

Purpose of the Study:

• To investigate the relationship between initial total prostate specific antigen (PSA) levels and PSA velocity.
• To determine if men with different PSA levels have varying probabilities of achieving a PSA velocity > 2 ng/ml/year.

Main Methods:

• Analysis of serial PSA measurements from 13,276 men in a large prostate cancer screening study.
• Calculation of PSA velocity using linear regression of PSA values from the year preceding diagnosis.
• Statistical comparison (ANOVA, Kruskal-Wallis, chi-square) of PSA velocity across different total PSA ranges.

Main Results:

• The proportion of men with PSA velocity > 2 ng/ml/year significantly increased with higher total PSA ranges (1% for ≤2.5 ng/ml to 74% for >10.0 ng/ml).
• Both mean and median PSA velocity were significantly higher in men with increasing total PSA levels.
• A strong positive correlation was observed between total PSA and PSA velocity.

Conclusions:

• PSA velocity is directly correlated with total PSA levels.
• Men with elevated initial PSA are substantially more likely to exhibit a high PSA velocity.
• High PSA velocity, particularly in the context of high initial PSA, is associated with increased prostate cancer mortality risk.