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Disorders of the Male Reproductive System01:20

Disorders of the Male Reproductive System

Men's health issues are increasingly recognized as significant, with several conditions posing common threats. Among these, testicular cancer is especially prevalent in younger men, particularly those aged 20 to 35 years. The disease often manifests as a painless mass in the testicles, sometimes accompanied by a sensation of heaviness or a dull ache.
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Prostate specific antigen testing among the elderly--when to stop?

Edward M Schaeffer1, H Ballentine Carter, Anna Kettermann

  • 1Department of Urology, The Johns Hopkins University School of Medicine, The James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, Maryland, USA.

The Journal of Urology
|February 28, 2009
PubMed
Summary
This summary is machine-generated.

For men aged 75-80, a prostate specific antigen (PSA) level below 3.0 ng/ml indicates a low risk of aggressive prostate cancer. PSA testing may be safely discontinued for this demographic.

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Area of Science:

  • Urology
  • Geriatric Medicine
  • Oncology

Background:

  • Prostate specific antigen (PSA) testing is widely used in elderly men.
  • Evidence suggests limited benefit from aggressive prostate cancer diagnosis and treatment in older men without high-risk disease.

Purpose of the Study:

  • To evaluate the relationship between PSA levels and the risk of developing aggressive prostate cancer in men of various ages.
  • To determine if PSA testing can be safely discontinued for specific elderly populations.

Main Methods:

  • Longitudinal cohort study of 849 men from the Baltimore Longitudinal Study of Aging.
  • Inclusion of men with serial PSA measurements, with or without prostate cancer.
  • Primary outcome: proportion of men by PSA and age who died of prostate cancer or developed aggressive disease (PSA ≥ 20 ng/ml or Gleason score ≥ 8).

Main Results:

  • No participants aged 75-80 with PSA < 3.0 ng/ml died of prostate cancer.
  • Men of all ages with PSA ≥ 3.0 ng/ml showed a continuously increasing probability of prostate cancer death (p < 0.001).
  • Time to death or aggressive cancer diagnosis after age 75 was significantly longer for PSA < 3 ng/ml compared to PSA ≥ 3 ng/ml (p = 0.019).

Conclusions:

  • Men aged 75-80 with PSA < 3.0 ng/ml have a low likelihood of dying from or experiencing aggressive prostate cancer.
  • PSA testing could potentially be discontinued for this specific elderly subgroup without compromising outcomes.