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Age-adjusted reference values for prostate-specific antigen in a multi-ethnic population.

Bashar Matti1, Kamran Zargar-Shoshtari1

  • 1Department of Surgery, The University of Auckland, Auckland, New Zealand.

International Journal of Urology : Official Journal of the Japanese Urological Association
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Summary

Establishing age-adjusted prostate-specific antigen (PSA) reference values in New Zealand reveals significant ethnic differences. These variations are crucial for accurate PSA test interpretation in diverse populations.

Keywords:
New Zealandethnic groupsprostate cancerprostate-specific antigenrace factorsreference values

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Area of Science:

  • Urology
  • Clinical Chemistry
  • Population Health

Background:

  • Prostate-specific antigen (PSA) testing is vital for prostate cancer screening.
  • Establishing accurate reference values is essential for effective PSA interpretation.
  • Existing PSA reference values may not adequately account for ethnic variations.

Purpose of the Study:

  • To determine age-adjusted prostate-specific antigen (PSA) reference values.
  • To investigate ethnic variations in PSA levels within New Zealand's diverse population.
  • To inform clinical practice regarding PSA interpretation.

Main Methods:

  • Data collected from 215,132 men aged 40-79 years in New Zealand (2009-2017).
  • Exclusion criteria included known prostate cancer, treatment with finasteride, or PSA > 20 ng/mL.
  • Age-adjusted 95th percentiles of log PSA were calculated for Māori, Pacific, Asian, and European ethnic groups.

Main Results:

  • PSA levels and upper reference limits increased with age across the cohort.
  • Significant ethnic differences in PSA levels were observed within age intervals.
  • These ethnic disparities were most pronounced in older age groups.

Conclusions:

  • Age-adjusted PSA reference values differ significantly among ethnic groups in New Zealand.
  • Clinical interpretation of PSA results must consider these ethnic variations.
  • The findings underscore the need for ethnicity-specific PSA reference ranges.