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Updated: Sep 19, 2025

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Defining Abnormal Prostate-Specific Antigen Values for Prostate Cancer Screening in the Spinal Cord Injury

Ryan W Fogg1, Sarah C Krzastek1,2, Nicole Vissichelli3,4

  • 1Department of Urology, Virginia Commonwealth University Health System, Richmond, Virginia.

The Journal of Urology
|June 17, 2025
PubMed
Summary
This summary is machine-generated.

Prostate-specific antigen (PSA) levels in men with spinal cord injury (SCI) may differ from the general population. New age-adjusted PSA thresholds are proposed for SCI patients to improve prostate cancer screening accuracy.

Keywords:
PSAcancer screening testlaboratory diagnosesprostate cancerspinal cord injury

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Area of Science:

  • Urology
  • Andrology
  • Public Health

Background:

  • Men with spinal cord injury (SCI) often have altered prostate-specific antigen (PSA) values due to urinary issues and hypogonadism.
  • Existing PSA reference ranges may not accurately reflect prostate cancer risk in the SCI population.

Purpose of the Study:

  • To establish specific PSA threshold values for men with SCI.
  • To guide prostate cancer screening decisions in this unique patient group.

Main Methods:

  • Analysis of national Veterans Affairs data from 1999-2019.
  • Inclusion of 34,899 male veterans with SCI and 240,131 PSA values.
  • Use of mixed-effect quantile regression for age and time-since-SCI adjusted PSA percentiles.

Main Results:

  • Generated age-adjusted PSA percentiles for the SCI population.
  • The 95th age-adjusted percentile PSA values ranged from 2.5 ng/mL (40-49 yrs) to 2.8 ng/mL (70-79 yrs).
  • PSA levels in SCI patients stagnate around 3 ng/mL as they age, unlike the non-SCI population.

Conclusions:

  • Age-adjusted PSA values for the SCI population can be reliably generated.
  • Established PSA reference ranges may need adjustment for SCI patients, particularly older individuals.
  • These findings support tailored prostate cancer screening strategies for men with SCI.