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Prostate-specific antigen testing in men between 40 and 70 years in Brazil: database from a check-up program
João Paulo Zambon1, Fernando G Almeida2, Raquel Dilguerian O Conceição3
1Department of Urology, Universidade Federal de Sao Paulo, SP, Brazil; Hospital Israelita Albert Einstein, SP, Brazil and Wake Forest University, Winston-Salem, North Carolina, USA.
Summary
Prostate-specific antigen (PSA) levels in Brazilian men undergoing check-ups were generally low, increasing with age and prostate size. Higher PSA values showed a moderate positive predictive value for prostate cancer detection via biopsy.
Area of Science:
- Urology
- Oncology
- Public Health
Background:
- Prostate-specific antigen (PSA) is a key biomarker for prostate health.
- Understanding PSA levels in diverse populations is crucial for early detection strategies.
- Brazilian men represent a significant demographic for prostate cancer research.
Purpose of the Study:
- To assess PSA levels in a large cohort of Brazilian men during routine check-ups.
- To investigate the correlation between PSA levels, prostate volume, and urinary symptoms.
- To evaluate the diagnostic accuracy of PSA thresholds for detecting prostate cancer.
Main Methods:
- A cross-sectional study involving 5015 Brazilian men aged 40-70 years.
- Urological evaluation, digital rectal examination, PSA testing, and ultrasonography were performed.
- Exclusion criteria included recent testosterone use or 5-alpha-reductase inhibitor use.
Main Results:
- Mean PSA levels increased with age: 0.9 ng/dL (40-50 yrs), 1.2 ng/dL (50-60 yrs), and 1.7 ng/dL (>60 yrs).
- PSA levels correlated positively with prostate size and International Prostate Symptom Score (IPSS).
- Biopsy positive predictive values were 25% for PSA 2.5-4 ng/mL and 40% for PSA >4 ng/mL.
Conclusions:
- Brazilian men in this study exhibited low overall PSA levels.
- PSA levels demonstrate a positive association with aging, prostate volume, and urinary symptom severity.
- PSA thresholds provide a valuable, albeit imperfect, tool for guiding prostate biopsy decisions.
