PSA Distribution and Clinical Correlates in Azerbaijani Men Presenting to a Urology Clinic

Prostate-specific antigen (PSA) levels are influenced by demographic and ethnic factors, but data from Azerbaijani men remain limited. PSA screening for prostate cancer must consider regional and ethnic variations. This study aimed to describe PSA levels and examine their clinical correlates in a hospital-based cohort of Azerbaijani men presenting to a urology clinic.

This retrospective cross-sectional study included 1175 Azerbaijani men aged 40-75 years who presented to a urology clinic without a known diagnosis of prostate cancer between January 2023 and December 2024. Data collected included age, total PSA, digital rectal examination (DRE)-estimated prostate size category, prostate volume (via ultrasound), maximum urinary flow rate (Q _max), and International Prostate Symptom Score (IPSS). Multivariate logistic regression was used to identify predictors of PSA elevation.

The median PSA level was 1.15 ng/mL (range: 0.001-112.1), with 85.1% of patients exhibiting levels below 4 ng/mL. PSA levels increased with age: 0.86 ng/mL in men aged 40-49, 1.2 ng/mL in those 50-64, and 1.44 ng/mL in men 65-75 years (p < 0.001). PSA correlated positively with age, IPSS, and prostate volume and negatively with Q _max (all p < 0.001). PSA levels varied with DRE-estimated prostate size category, showing significant differences between Categories 2 and 3 (p = 0.002). Multivariate analysis identified age as an independent predictor of PSA ≥ 4 ng/mL.

In this hospital-based cohort of Azerbaijani men, PSA levels were positively associated with age, and age was independently associated with PSA ≥ 4 ng/mL. These findings provide important regional data and support further investigation of age-specific PSA patterns in the Azerbaijani population.